Dyslipidemia - Abnormal Blood Lipid Levels and Its Impact on Health

Introduction

Lipids like triglycerides or cholesterol are absorbed from the gut and carried through the body as lipoproteins for energy, bile acid formation, and steroid production. LDL (low-density lipoprotein), HDL (high-density lipoprotein), and other types of cholesterol are major contributors to this pathway. An imbalance in these contributors can lead to dyslipidemia.

What Is Dyslipidemia?

Dyslipidemia is unhealthy or abnormal levels of one or more types of fat (lipid) in the body. Blood contains mainly three types of lipids; they are; high-density lipoprotein, low-density lipoprotein, and triglycerides. In dyslipidemia, the LDL and triglyceride levels are too high, which also means low HDL levels. LDL refers to ‘bad’ cholesterol as it can build up in the form of plaques or clumps in arteries' walls, leading to heart complications and the main cause of heart attack. HDL, in turn, is referred to as ‘good’ cholesterol and helps in removing LDL from the blood. Triglycerides are the result of calorie intake that does not burn right away. They are stored as fat cells. They release energy whenever needed. High LDL and triglycerides can be the main cause of stroke and heart attack. Low levels of HDL are associated with a high risk of heart disease.

What Are the Types of Dyslipidemia?

Dyslipidemia is divided into primary and secondary types. Primary dyslipidemia is inherited, and secondary dyslipidemia is an acquired condition. It can also develop due to other causes like obesity and diabetes. Dyslipidemia is also known as hyperlipidemia. Hyperlipidemia is due to high levels of LDL or triglycerides. Dyslipidemia refers to a high and low range of blood fats.

Primary dyslipidemia-specific types are:

• Familial Hypercholesterolemia and Polygenic Hypercholesterolemia - They are high in total cholesterol. Total cholesterol means the sum of HDL and LDL levels, with half triglyceride levels. Total cholesterol level should be under 200 mg/dL.

• Familial Combined Hyperlipidemia - This is the most common inherited cause of high triglycerides and high LDL cholesterol. Familial combined hyperlipidemia can develop issues in teens or in their 20s. Also, a higher risk for early coronary artery disease can lead to a heart attack.

• Familial Hypobetalipoproteinemia - High levels of apolipoprotein B, a protein that is a part of LDL cholesterol.

What Are the Causes of Dyslipidemia?

The causes of dyslipidemia are behaviors like:

• Obesity.

• Sedentary lifestyle.

• Consumption of high saturated fats and trans fat.

• Cigarette smoking.

• Excess alcohol consumption.

• Individuals are at high risk if one or both parents has dyslipidemia.

What Are the Risk Factors of Dyslipidemia?

The higher risk of getting dyslipidemia is when one of both parents has dyslipidemia. Age is also a risk factor, and increasing age can be a risk factor for high cholesterol. Women are more likely to get lower LDL levels than men until menopause. After that, the LDL level starts to rise. Other medical conditions that raise the risk are:

• Chronic kidney disease.

• Hypothyroidism.

• Type 2 diabetes.

What Are the Signs and Symptoms of Dyslipidemia?

Unless the condition turns severe, dyslipidemia acts as a silent attacker. In most cases, the individual is unaware of having it. It is usually diagnosed during a routine blood analysis. Untreated severe dyslipidemia can lead to PAD (peripheral artery disease) and CAD (coronary artery disease). Both are capable of heart attacks and strokes. Common symptoms include:

• Indigestion and heartburn.

• Dizziness.

• Heart palpitations.

• Cold sweats.

• Chest pain.

• Leg pain, mainly while standing and walking.

• Pressure or tightness in the chest.

• Shortness of breath.

• Pressure and tightness of jaw, neck, shoulders, and back.

• Daytime exhaustion and sleep problems.

• Nausea and vomiting.

• Fainting.

• Swelling of ankles, legs, feet, veins of the neck, and stomach.

How Is Diagnosis Made for Dyslipidemia?

Usually, dyslipidemia is diagnosed by a simple blood test. The test reveals LDL, HDL, and triglycerides levels, ranging from high to low or in a healthy range. Annual blood work is a better idea for a routine test; the levels change from time to time. If medication is recommended for dyslipidemia, the healthcare provider may ask for frequent blood tests.

What Is the Treatment for Dyslipidemia?

Some individuals can just change their lifestyle to improve their cholesterol. Other individuals need medication along with lifestyle changes. The lifestyle changes include:

• Eating healthy foods.

• Quitting smoking and reducing alcohol consumption.

• Sleep at least seven to eight hours each night.

• Exercising.

• Losing a few pounds to reach a healthy weight.

• Keep low-stress levels.

Medications like statins are used to treat high cholesterol. Statins help to decrease bad cholesterol in the blood. The provider may prescribe medicines like statin alone or another medicine in addition to statin. Other cholesterol-controlling non-statin drugs like Ezetimibe, fibrates like Fenofibrate, and PCSK9 inhibitors are used.

What Is the Prognosis of Dyslipidemia?

The prognosis of an individual with dyslipidemia has an atherosclerotic cardiovascular disease risk. Risk factors are based on lipid levels, race, tobacco use, gender, diabetes, and hypertension history. The percentage of risk depends on the cardiovascular events in 10 years, and the risk decreases if the risk factors are optimal.

What Is the Complication of Dyslipidemia?

The significant complication of dyslipidemia is cardiovascular disease. Other complications include acute myocardial infarction, stroke, and sudden cardiac death. Appropriate statin and dyslipidemia treatment significantly reduced all risks of cardiovascular events, cardiovascular mortality, and all-cause mortality.

What Is the Differential Diagnosis of Dyslipidemia?

The differential diagnosis of dyslipidemia is:

• Biliary obstruction.

• Pregnancy.

• Nephrotic syndrome.

• Hypothyroidism ( when the thyroid gland fails to produce enough hormones, hypothyroidism develops.).

• Drugs (Glucocorticosteroids, Tamoxifen, thiazides).

Conclusion

Dyslipidemia can cause plaque deposition in the arteries and lead to the risk of heart health, causing stroke and heart attack. By following a healthy lifestyle, one can reduce the risk of getting these complications. More exercise and a healthy diet can improve cholesterol levels. Consult a doctor if other medically compromised conditions like high blood pressure, high blood sugar, and high cholesterol are detected. Regular exercise with weight loss can improve cholesterol profile. If a family history of cholesterol is present, be proactive, and lead a healthy life before the cholesterol levels move toward the unhealthy side.