Hyperlipaemia, also referred to as hyperlipidemia, describes a condition where there are abnormally high levels of fats, known as lipids, in the bloodstream. While lipids are necessary for bodily functions, an excess can contribute to various health concerns over time. This condition is quite common, particularly in developed regions globally.
What is Hyperlipaemia?
The primary lipids of concern are cholesterol and triglycerides. Cholesterol is a waxy, fat-like substance that the body uses to build cells and produce hormones. Triglycerides, on the other hand, store unused calories and provide the body with energy.
These lipids are transported through the bloodstream by proteins called lipoproteins. Low-density lipoprotein (LDL) cholesterol is often called “bad” cholesterol because high levels can lead to fatty buildups in artery walls. High-density lipoprotein (HDL) cholesterol is considered “good” cholesterol as it helps remove excess cholesterol from the arteries and transport it back to the liver for removal from the body.
Common Causes and Risk Factors
Hyperlipaemia can arise from a combination of lifestyle choices and underlying medical conditions. Dietary habits play a significant role, with diets high in saturated and trans fats, red meat, and full-fat dairy products contributing to elevated lipid levels. A lack of regular physical activity and excessive alcohol consumption are also recognized lifestyle factors that can negatively impact lipid profiles. Smoking is another habit that can lower “good” HDL cholesterol and injure blood vessel walls.
Beyond lifestyle, several medical conditions can predispose an individual to hyperlipaemia. Genetic factors can cause primary hyperlipidaemia. Conditions such as diabetes, hypothyroidism, and certain kidney diseases, like nephrotic syndrome and chronic renal failure, can also lead to acquired hyperlipaemia. Additionally, some medications, including certain birth control pills, diuretics, and antiretrovirals, may influence cholesterol levels.
Identifying Hyperlipaemia
Hyperlipaemia often presents without any noticeable symptoms in its initial stages, making regular health screenings important for detection. In rare instances, particularly with inherited forms of the condition, certain physical signs might appear. These can include yellowish, fatty deposits under the skin called xanthomas, or rings around the iris of the eye known as corneal arcus.
Diagnosis primarily relies on a blood test called a lipid panel or lipid profile. This test measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels in the blood. Elevated readings in these measurements indicate hyperlipaemia. Healthcare providers often recommend adults aged 20 and older have their cholesterol checked every four to six years.
Managing and Treating Hyperlipaemia
Managing hyperlipaemia involves a two-pronged approach: lifestyle modifications and, when necessary, medical interventions. Dietary changes are central to treatment, emphasizing a heart-healthy diet low in saturated and trans fats. This includes choosing lean protein sources like fish or chicken over red meat, avoiding full-fat dairy, and limiting processed foods. Incorporating more fruits, vegetables, whole grains, and foods rich in omega-3 fatty acids, such as salmon and flaxseeds, can help improve lipid levels.
Regular physical activity is also recommended, with a goal of at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking. Weight management through a balanced diet and exercise can reduce cholesterol levels. Quitting smoking is another important step, as smoking can lower HDL cholesterol and narrow blood vessels.
When lifestyle changes alone are not sufficient, medical interventions become necessary. Statins are a common first-line medication, working by blocking a substance the liver needs to produce cholesterol, thereby reducing LDL cholesterol levels. Other medications, such as fibrates, may be used to lower triglycerides and can sometimes increase HDL cholesterol. Bile acid sequestrants and cholesterol absorption inhibitors are also options that work by preventing the absorption of cholesterol or binding to bile acids in the intestine, leading to reduced cholesterol in the bloodstream. Adherence to prescribed treatment plans and regular monitoring of lipid levels every three to six months are important for management.
Long-Term Health Implications
If hyperlipaemia remains unmanaged, it can lead to long-term health consequences, primarily affecting the cardiovascular system. The excess lipids contribute to atherosclerosis, a condition where fatty deposits, known as plaque, build up and harden the arteries. This narrowing of arteries can impede blood flow, increasing the likelihood of conditions such as coronary artery disease, which can result in a heart attack.
Uncontrolled hyperlipaemia also raises the risk of stroke, which occurs when a blood clot blocks blood flow to the brain. Peripheral artery disease, affecting blood vessels in the limbs, is another potential complication. In cases of very high triglyceride levels, there is an increased risk of developing pancreatitis, an inflammation of the pancreas.