Hyperlipidemia: Symptoms, Causes and Treatment

It’s a known fact that your body will suck up more cholesterol if you take extra from another person’s plate. This proverb directly depicts eating more by taking from the other’s plate, which will show an increase in cholesterol. High cholesterol is the cause of many diseases. Hyperlipidemia is one such condition that is caused by lipids comprising cholesterol.

What is Hyperlipidemia?

Hyperlipidemia refers to the condition of having too many lipids (fats) in your blood. This is also called dyslipidemia or high cholesterol. However, cholesterol and triglycerides are together called lipids.

In general, the cholesterol needed for you is generated by your liver, which helps digest food and produce hormones. Rather than generating cholesterol on your own, you also get cholesterol from foods like meat, dairy products, and some other foods. The cholesterol you eat will be more than the cholesterol generated in you, which is extra.

Too much cholesterol means 200 mg/dL to 239 mg/dL, which is borderline high, and 240 mg/dL, which is high. They can block your artery highways, where blood flows around your body. This blocking will damage your organs, which don’t get sufficient blood from your arteries. So, higher cholesterol and higher lipids are unhealthy.

Hyperlipidemia Symptoms 

In some cases of hyperlipidemia, you might not have any symptoms. However, in other cases, hyperlipidemia shows many symptoms. Here are the symptoms of hyperlipidemia:

• Chest pain
• Pain in your feet or toes
• Leg cramps, especially in your calves
• Difficult breathing
• Shortness of breath while you are active
• Confusion
• Trouble speaking
• Weakness in your arm

Causes of Hyperlipidemia

Many causes are responsible for hyperlipidemia. Here are the causes of hyperlipidemia:

1) Diet

Eating foods high in cholesterol, saturated fats, and trans fats could increase your blood cholesterol level. The higher cholesterol levels lead to higher lipids. The high-cholesterol-containing foods are:

• Egg yolks
• Meat
• Fried and processed foods
• Cheese
• Ice cream
• Pastries

2) Smoking

Smoking is the cause of many diseases. Smoking increases lipid contents, thus resulting in a higher risk of cardiovascular disease. This is because smokers have higher triglyceride (TG) levels when compared to non-smokers. As mentioned above, triglyceride is also a component of lipids.

3) Drinking alcohol

Drinking alcohol causes many health issues, similar to smoking. Too much alcohol intake is linked with hypertriglyceridemia. This is due to the increased production of triglycerides in the liver and the increased secretion of hepatic VLDL. Drinking too much alcohol might completely damage your liver.

4) Some lifestyle 

Some habits that you practice daily will also contribute to hyperlipidemia. A few factors in life also cause hyperlipidemia. Such factors are:

• Overweight
• Stressed
• Not doing enough exercise
• Eating foods containing a lot of saturated fats or trans fats
• Always sit or sit too much instead of being active

5) Medical conditions

Many health problems cause an increase in cholesterol levels, thus increasing hypertriglyceridemia. Those health issues include:

• Liver disease 
• Diabetes
• Lupus
• Kidney disease 
• Pancreas issues 
• Multiple myeloma
• HIV
• Primary biliary cholangitis(a gallbladder issue) 
• Polycystic ovary syndrome (PCOS)
• Sleep apnea
• Hypothyroidism

6) Medications

Consuming some medicines for some health issues can affect your cholesterol levels. Those medications that can cause them are: 

• Beta-blockers
• Diuretics
• Steroids
• Hormonal birth control
• Antiretrovirals for HIV
• Hormonal birth control

7) Genetic Hereditary

The inherited genes can make your cholesterol levels unhealthy. Familial combined hyperlipidemia (FCH) is a hereditary metabolic issue that shows elevated levels of total triglycerides, cholesterol, low-density lipoprotein (LDL) cholesterol, and decreased levels of high-density lipoprotein (HDL) cholesterol. FCH is a mostly occurring hereditary lipid disorder. 

Hyperlipidemia can go through families. People inheriting such a condition can have very high cholesterol. Those people have a higher risk of having a heart attack, even while they’re young.

Hyperlipidemia Treatment

There are several treatments for hyperlipidemia. Here are the treatments for Hyperlipidemia. 

1) Lifestyle Modifications

Some lifestyle changes will help treat the hyperlipidemia. Those lifestyle changes that help treat hyperlipidemia include:

• Eat a healthy diet by including veggies and fruits.
• Include foods that are low in trans fats and saturated fats in your diet. For that, you could replace your normal cooking oils and other fats with substitute oils like olive, sesame, sunflower, safflower, and canola oils while cooking.
• Practice eating more fibre-rich foods, like apples, bananas, oatmeal, pears, prunes, chickpeas, lentils, kidney beans, and lima beans. Soluble fibre lowers your LDL cholesterol.
• Eat fish only twice a week. Tuna, herring, salmon, mackerel, and trout are some of the fatty fish that consist of omega-3 fatty acids, which help reduce your triglycerides.
• You can obtain omega-3s from flaxseed, walnuts, and canola oil.
• Do not eat or drink sugary drinks or added sugars.
• Do not eat fried or processed meats.
• Do not smoke; if you already have that habit, then quit it. After you stop smoking, your HDL (good cholesterol) levels will rise. To quit smoking, you could concentrate on your good hobbies or get suggestions from your doctor. Some medications might help you quit smoking.
• Make sure that you sleep for a minimum of 7 hours every night. This is because poor sleep might cause high blood pressure and heart disease.
• Manage the level of your stress. This is because high stress might cause inflammation in your body, which could increase your blood pressure and lower your HDL levels.
• Practice good habits to lower stress, like meditation, cycling (as per your ability, not more), journaling, yoga, exercise, counselling, etc.
• Do not drink or limit drinking alcohol.
• Make sure that you exercise for up to 30 minutes of moderate-intensity activity for at least three days a week.
• Try to have a brisk walk each day of the week for 10 to 15 minutes. 

2) Medications

Some people need proper medication, along with the proper diet and lifestyle changes, to treat hyperlipidemia. Such medicines that help treat the hyperlipidemia condition include:

i) Cholesterol absorption inhibitors

Cholesterol absorption inhibitors are medications that stop the cholesterol intake from being driven into the human body by the intestine. Cholesterol absorption inhibitors work along with the statins. 

ii) Statins

Statins are medications that help prevent your liver from producing cholesterol. They’re a popular option to reduce the level of cholesterol in your blood. But statins show serious side effects in some people, like mental confusion, muscle pain, digestion issues, liver damage, etc. If it does not suit you, just stop using your statin medications.

iii) PCSK9 inhibitors

PCSK9 inhibitors are medications that inhibit PCSK9 and lower LDL, or bad cholesterol. A protein called PCSK9 in your liver could raise your cholesterol level. When you intake your doctor-prescribed PCSK9 inhibitors, they will block the receptors of the protein, which permits your liver to remove more cholesterol. Currently, the FDA-approved medications alirocumab (Praluent) and evolocumab (Repatha) are the two in use. A new drug known as inclisiran interferes with your body’s production of PCSK9, thus helping lower hyperlipidemia.

iv) Nicotinic acid

Nicotinic acid reduces your LDL cholesterol and triglycerides, thus increasing your HDL cholesterol. This also impacts the way your liver makes fat.

v) Bempedoic acid 

Bempedoic acid (Nexletol) working is similar to that of the working of statins in your body. But this medication does not cause any muscle pain.

vi) Bile-acid binding resins

Bile-acid-binding resins change your body’s use of cholesterol. They get stuck to the bile, which is necessary for digestion. Your liver must generate more bile, for which it requires cholesterol. This causes less cholesterol in your bloodstream. 

vii) Niacin

Niacin limits the quantity of LDL and VLDL your liver makes. Higher LDL and VLDL might cause many diseases. However, your doctor will not prescribe niacin until you are able to take statins.

vii) Fibrates

Fibrates are the medications that help reduce the amount of very low density lipoprotein (VLDL) your body produces and help your body clear off the triglycerides from your blood. If you intake these medications with statin, then it might increase the statin side effects. Fenofibrate (like Tricor and Fenoglide) and gemfibrozil (Lopid) are some of the famous Fibrates medications.

viii) Omega-3 supplements

You can use Omega-3 supplements if your doctor suggests them for you. Omega-3 supplements help lower triglycerides, which form lipids other than cholesterol. But consult your doctor before you take them. This is because they might interact with the other medicines.

ix) Other supplements

Supplements that you use other than your medications, like berberine, flaxseed, garlic, green tea, and nattokinase, could help treat hyperlipidemia. Medications alone, are not mere enough to treat the Hyperlipidemia, so eating certain foods like cholesterol and triglycerides lowering foods will help to treat this condition.  

3) Surgery 

In rare cases, some surgical procedures like coronary artery bypass surgery, percutaneous transluminal coronary angioplasty, partial ileal bypass, and liver transplant might be used to treat hyperlipidemia.

i) Coronary Artery Bypass surgery

Coronary artery bypass grafting (CABG) is also called heart bypass surgery. This treatment method helps improve the blood flow to the heart. This medical procedure is performed when the arteries supplying blood to the heart, known as the coronary arteries, are blocked or restricted.

ii) Percutaneous transluminal coronary angioplasty (PTCA) 

Percutaneous transluminal coronary angioplasty (PTCA) helps open the blocked or stenosed coronary arteries, permitting unobstructed blood flow to the myocardium. This method, also called percutaneous coronary intervention (PCI), aids in opening the blocked or stenosed coronary arteries, permitting unobstructed blood flow to the myocardium.

iii) Partial ileal Bypass

Partial ileal bypass shows an improvement in the blood lipid profiles of patients affected by the myocardial infarction.

iv) Liver transplantation or Hepatic transplantation

Liver transplantation is the procedure in which the diseased liver of a person is replaced by the healthy liver of another person. This liver transplantation treatment is a bit risky, as the donor organs are a major limitation.

Hyperlipidemia Diagnosis

There are many ways to diagnose hyperlipidemia. Here are the methods involved in diagnosing hyperlipidemia.

1) Physical tests

Your doctor will check for fatty deposits on the body and cholesterol deposits around the eyes, on the knees, ankles, elbows, and hands. In physical exams, the patients will be asked by their doctor if they have seen any symptoms of blocked arteries.

2) Your medical history

To diagnose hyperlipidemia, your doctor may suggest a test that checks for the levels of cholesterol and triglycerides in your blood. Your medical history and your ancestor’s medical history will help diagnose hyperlipidemia. This is because hyperlipidemia is sometimes linked to genes that you inherit from your parents.

3) Lab tests

When hyperlipidemia has no symptoms, the lab tests help detect the condition. Your doctor might suggest a blood test called a lipid panel or a lipid profile. Usual lipid blood tests involve a measurement of total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, and triglycerides.

This lipid panel will help your doctor with the hyperlipidemia diagnosis. The tests given below help determine cholesterol levels.

• Lipoprotein (a)
• High-sensitivity C-reactive protein (hs-CRP)
• Coronary calcium scan
• Apolipoprotein B

Hyperlipidemia Prevention

There are many ways in which hyperlipidemia could be prevented. Here are some ways to prevent hyperlipidemia.

• Stop smoking
• Maintain your weight
• Exercise regularly
• Increase the dietary fibre in your food
• Eliminate foods with high trans fats
• Have a proper and nutritious diet
• Eat a heart-healthy diet
• Stop or limit alcohol consumption
• Eat low-dairy fats
• Be physically active
• Manage your stress.
• Stop or limit the use of pharmaceutical medicines that cause hyperlipidemia
• Substitute the oils

Conclusion

Hyperlipidemia is an elevation in both the LDL and lipids. Bad cholesterol (LDL) usually hardens the cholesterol deposits (plaque) and makes them collect inside your blood vessels. Very low-density lipoprotein (VLDL) is another type of traffic blocker since it carries the triglycerides and makes them pile up into the artery plaque. Some diets, lifestyle habits, medications, medical issues, etc. cause hyperlipidemia. There are several ways to treat hyperlipidemia, like taking medications and following certain lifestyles. 

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