Hyperlipidemia Treatment - Cholesterol and Lipid Disorders

Hyperlipidemia is the condition where blood fats (lipids) such as cholesterol and triglycerides are above normal levels. Known commonly as “high cholesterol,” this condition is one of the most common health problems of the modern age and is among the primary causes of cardiovascular diseases.

What is Hyperlipidemia?

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Our body needs a certain amount of cholesterol to maintain cell structure, produce hormones, and carry out digestive processes. However, excessively high levels of lipids in the blood can accumulate on vessel walls, leading to plaque formation (atherosclerosis) and eventually vascular blockages.

Hyperlipidemia is generally examined under two main headings:

1. Hypercholesterolemia: High levels of cholesterol in the blood.
2. Hypertriglyceridemia: High levels of triglycerides in the blood.

Types of Cholesterol and Their Meanings

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It is important to understand the different types of cholesterol to properly evaluate the lipid profile:

• LDL (Low-Density Lipoprotein): Known as “bad cholesterol.” It tends to accumulate on vessel walls and form plaque. Our primary goal in treatment is to lower LDL levels.
• HDL (High-Density Lipoprotein): Known as “good cholesterol.” It carries cholesterol from tissues to the liver, allowing it to be excreted from the body. High levels protect heart health.
• Triglyceride: Another type of fat found in the blood. Is the body’s energy store, but high levels increase the risk of heart disease.
• Total Cholesterol: The sum of all cholesterol components in the blood.

Causes of Hyperlipidemia

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Causes of high cholesterol can be genetic (hereditary) or acquired (lifestyle-related). Both factors are present together in most patients.

Lifestyle Factors (Modifiable Causes)

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• Unhealthy Diet: A diet rich in saturated fats (red meat, full-fat dairy products) and trans fats (processed foods, fried foods) raises cholesterol.
• Physical Inactivity: Lack of regular exercise raises LDL while lowering HDL.
• Obesity: Having a body mass index over 30 significantly increases the risk of hyperlipidemia.
• Smoking: Smoking lowers good cholesterol (HDL) levels and damages blood vessel structure.
• Alcohol Consumption: Excessive alcohol consumption can raise triglyceride levels.

Medical Conditions and Genetic Factors

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• Familial Hypercholesterolemia: A genetic disorder resulting in the body’s inability to remove LDL cholesterol from the blood. Cholesterol levels are very high from very early ages in these individuals.
• Diabetes: High blood sugar increases VLDL and triglycerides while lowering HDL.
• Hypothyroidism: Underactive thyroid gland raises total cholesterol levels.
• Kidney Diseases: Chronic kidney failure and nephrotic syndrome impair lipid metabolism.
• Certain Medications: Steroids, some blood pressure medications, and rhythm regulators can affect the lipid profile.

Symptoms and Diagnosis of Hyperlipidemia

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High cholesterol is usually a silent killer. It may not show any symptoms until vessels are significantly blocked. Most patients are diagnosed during routine blood tests or after developing a complication like a heart attack/stroke.

Rare physical signs include:

• Xanthelasma: Yellowish fat deposits on or around eyelids.
• Xanthoma: Fat accumulation in the form of nodules on elbow, knee, or heel tendons.
• Corneal Arcus: A whitish ring around the colored part of the eye (suggests genetic transmission, especially in individuals under 45).

Diagnosis Method: Diagnosis is made with a simple blood test (Lipid Profile) performed after 9-12 hours of fasting. Total Cholesterol, LDL, HDL, and Triglyceride levels are checked in this test.

Hyperlipidemia Treatment

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The main goal of hyperlipidemia treatment is to reduce the risk of heart attack, stroke, and peripheral artery disease. The treatment plan is determined individually based on the patient’s current risk factors (age, gender, diabetes, hypertension, smoking status) and baseline lipid levels.

1. Lifestyle Changes

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The first step of treatment is always lifestyle changes. These changes must be maintained even if medication therapy is started.

• Heart-Friendly Diet:
  • Limit saturated fat intake (red meat, butter, full-fat milk).
  • Avoid trans fats completely.
  • Increase fiber-rich foods (vegetables, fruits, legumes, whole grains).
  • Consume fish at least 2 days a week (Source of Omega-3).
  • Prefer healthy fats like olive oil, hazelnuts, walnuts.
• Weight Control: Reaching ideal weight and reducing waist circumference positively affects lipid profile.
• Regular Exercise: At least 150 minutes of moderate-intensity aerobic exercise (walking, swimming, cycling) per week increases HDL and helps lower LDL.
• Quitting Smoking: Raises HDL cholesterol and rapidly reduces cardiovascular risk.

2. Medical (Drug) Treatment

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Medication therapy is started in patients where lifestyle changes are insufficient or cardiovascular risk is high.

• Statins: The most effective and widely used drug group that reduces cholesterol production in the liver (e.g., Atorvastatin, Rosuvastatin). They not only lower cholesterol but also stabilize plaque inside the vessel, preventing rupture (heart attack).
• Cholesterol Absorption Inhibitors (Ezetimibe): Reduces cholesterol absorption from the intestines. Usually combined with statins.
• PCSK9 Inhibitors: New generation injection therapies that increase the liver’s capacity to clear LDL from the blood. Used in patients with genetic high cholesterol or those who cannot tolerate statins.
• Fibrates: Especially used to lower high triglycerides.
• Omega-3 Fatty Acids: High-dose pure fish oil preparations can help lower triglycerides.

Treatment Targets

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The LDL cholesterol target to be reached in treatment varies according to the person’s cardiovascular risk level:

• Very High Risk Patients: (Those who have previously had a heart attack, stent, bypass, or have diabetes) -> LDL < 55 mg/dL
• High Risk Patients: -> LDL < 70 mg/dL
• Moderate Risk Patients: -> LDL < 100 mg/dL
• Low Risk Patients: -> LDL < 116 mg/dL

Frequently Asked Questions

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Appointment and Contact

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You should consult a healthcare provider for hyperlipidemia diagnosis, risk assessment, and personalized treatment planning. Do not delay your heart health.

📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul

📞 Phone: +90 212 665 50 50 (Ext: 4012)

This content has been prepared by Assoc. Prof. Dr. Habib ÇİL for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.

Related Topics

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Other cardiology conditions and treatments related to hyperlipidemia:

• Coronary Artery Disease - Vascular blockage
• Hypertension - High blood pressure
• Cardiovascular Prevention - Heart health risk management
• Myocardial Infarction - Heart attack treatment