Hyperlipidemia; acquired

Causes and Risks:
Hyperlipidemia is caused by excess lipids or fatty substances in the blood and is an important risk factor in developing atherosclerosis and heart disease . Hyperlipidemia may be caused by genetic factors, as in certain familial diseases, or by secondary factors in acquired hyperlipidemia.

Forms of lipids in the blood are cholesterol , triglycerides , and lipoproteins, which are molecules of fat and cholesterol linked to protein . Types of lipoproteins are: very low-density lipoproteins ( VLDL ), low-density lipoproteins ( LDL ) and intermediate-density lipoproteins (IDL). Chylomicrons are also classified as lipoproteins and are composed of triglycerides, cholesterol and protein. There are also high-density lipoproteins ( HDL ) that are inversely related to heart disease risk and are therefore known as "antirisk" factors.

There are 6 types of hyperlipidemia which are differentiated by the type(s) of lipids that are elevated in the blood. Some of the types may be due to a primary disorder such as a familial hyperlipidemia, and some are due to secondary causes. Secondary causes of hyperlipidemia are related to diseases associated with hyperlipidemia, dietary risk factors, and drugs associated with hyperlipidemia.

Disease risk factors are a history of insulin dependent diabetes mellitus , non-insulin dependent diabetes mellitus , hypothyroidism , Cushing's syndrome , and certain types of renal failure . Drug risk factors are birth control pills; hormones such as estrogen and corticosteroids; certain diuretics; and beta-blockers. Dietary risk factors are dietary fat intake per total calories greater than 40%; saturated fat intake per total calories greater than 10%; cholesterol intake greater than 300 milligrams per day; habitual excessive alcohol use ; and obesity . The incidence is 1 out of 100 people and is higher among men than women.

Prevention:
Screening for hyperlipidemia should be a part of a routine health evaluation for people between 20 and 30 years old. Reducing dietary risk factors by maintaining ideal body weight , eating a well balanced, low fat diet, and limiting cholesterol intake will help prevent the onset of hyperlipidemia.

Symptoms:
There are no symptoms.

Signs and Tests:
Physical examination and laboratory tests are done to identify secondary causes of hyperlipidemia or familial disorders if lipoprotein analysis is elevated.

Note: Normal values for cholesterol and triglycerides are dependent on age.

This disease may also alter the results of the following tests:



Treatment:
The goal of therapy is to reduce the risk of atherosclerosis and cardiovascular disease through therapy aimed at lowering the blood lipid levels.

Dietary modification is the initial step in treatment. For overweight individuals, weight reduction to ideal body weight is recommended. Reduction of total calories, cholesterol , and saturated fat is appropriate for most people. The degree of dietary restriction is proportional to the degree of the hyperlipidemia.

If there is no improvement in lipid blood levels within 2 months after maximal dietary modification, drug therapy is generally initiated. The type of drug chosen depends upon the type of lipoprotein elevated in the serum. Several types of medications are available. Bile sequestrant resins, cholestyramine, colestipol, lovastatin, and nicotinic acid are frequently used; others are available. If there is no response to a drug after 2 to 3 months of therapy, it should be discontinued. (DON'T STOP TAKING PRESCRIPTION MEDICATION WITHOUT CONSULTING YOUR HEALTH CARE PROVIDER.)

Prognosis:
Drug and diet therapy is likely to continue throughout the life of the affected individual. Periodic monitoring of blood levels is necessary to determine the response to treatment. In studies, reduction of high cholesterol levels has shown a decrease in the progression of atherosclerosis .

Complications:



Call Your Healthcare Provider:
This condition is usually found by the health care provider when lab work is examined. If you have hyperlipidemia, be aware that you are at increased risk for heart disease .

Call for an appointment with your health care provider if you have this condition and have not scheduled periodic monitoring of blood lipid levels.