Key takeaways
- Hyperlipidemia, characterized by high levels of lipids (fats) in the blood, often doesn’t present symptoms until it leads to serious complications, such as a heart attack or stroke.
- You can lower your chances of developing hyperlipidemia, manage the condition, and reduce the risk of complications with certain lifestyle changes, such as maintaining a moderate weight and being physically active.
- If lifestyle changes aren’t enough, medications like statins and injectable drugs are available to help lower cholesterol and triglyceride levels.
There are a few types of lipids in the blood:
- low-density lipoprotein (LDL), or “bad” cholesterol
- high-density lipoprotein (HDL), or “good” cholesterol
- triglycerides, a blood fat that isn’t cholesterol
LDL can accumulate into clumps of plaque in your artery walls, making them hard and narrow and reducing your blood flow. HDL helps clear LDL from your body.
Your triglyceride levels can become elevated when you consistently consume more calories than you burn.
The term “hyperlipidemia” can refer to any elevated levels of lipids, but it usually describes high LDL, high triglycerides, or both. You may also hear the term “hypercholesterolemia,” which refers specifically to high levels of cholesterol, usually high LDL or total cholesterol.
There are two main classifications of hyperlipidemia with different underlying causes: familial (primary) and acquired (secondary).
Familial hyperlipidemia
The familial types of hyperlipidemia stem from genes you inherit from one or both of your parents. Mutations in certain genes, like LDLR or PCSK9, can cause elevated lipid levels
There are a few subtypes of familial hyperlipidemia:
- familial hypercholesterolemia, which involves very high LDL and total cholesterol levels
- familial hypertriglyceridemia, which involves high triglyceride levels
- familial combined hyperlipidemia, a common type, which leads to high LDL and triglyceride levels
Other subtypes, like familial dysbetalipoproteinemia, are less common.
Acquired hyperlipidemia
Acquired hyperlipidemia is most often the result of one or a combination of certain personal factors, as laid out in the following table.
| Lifestyle factors | Underlying conditions | Medications |
|---|---|---|
|
|
|
This table isn’t comprehensive; there may be other factors affecting your cholesterol. A doctor
Hyperlipidemia often doesn’t cause symptoms until it leads to a serious complication, such as peripheral artery disease, heart attack, or stroke. These can occur when high cholesterol has led to plaque buildup in your blood vessels that limits or completely blocks the flow of blood.
People with familial hyperlipidemia may experience symptoms of complications earlier in life, such as:
- chest pain
- heart attack
- cramping in the calves while walking
- sores on the toes that don’t heal properly
- stroke symptoms, including:
- trouble speaking
- drooping on one side of the face
- weakness in the extremities
The only way to confirm a hyperlipidemia diagnosis is to have your doctor request a blood test called a lipid panel or lipid profile. This test determines your cholesterol and triglyceride levels.
A healthcare professional will take a sample of your blood and send it to a lab for testing. Your report will show your levels of:
- total cholesterol
- LDL cholesterol
- HDL cholesterol
- triglycerides
Most adults should start cholesterol screenings at age 19 and do a lipid panel every 5 years. Your doctor may recommend more frequent screenings based on your specific situation.
Lifestyle changes are often key to managing hyperlipidemia at home. Even if your hyperlipidemia is inherited, lifestyle changes are still an essential part of treatment.
These changes alone may be enough to reduce your risk of complications like heart disease and stroke.
If you’re already taking medications to manage hyperlipidemia, lifestyle changes can improve their cholesterol-lowering effects.
Eat a heart-healthy diet
Making heart-healthy changes to your diet can lower your LDL cholesterol levels and increase your HDL cholesterol levels. Here are a few changes you can make:
- Choose healthier fats: Limit saturated fats that are found primarily in red meat, bacon, sausage, full fat dairy products, and many ultra-processed foods. Choose leaner proteins like chicken, turkey, and fish when possible. Use healthier unsaturated fats like olive, avocado, and canola oil for cooking.
- Eat more omega-3s: Omega-3 fatty acids have many heart benefits. You can find them in some types of fish, including salmon, mackerel, and herring. They can also be found in some nuts and seeds, like walnuts and flaxseeds.
- Increase your fiber intake: All fiber is heart-healthy, but soluble fiber in particular — which is found in foods like oats, bran, fruits, beans, and vegetables — can lower your LDL and total cholesterol levels.
- Eat more fruits and veggies: They’re often high in fiber and vitamins and low in saturated fat.
You can also try a particular eating pattern, like the Mediterranean diet, which
Maintain a healthy-for-you weight
If you have a higher body weight, losing weight can help moderate your total cholesterol and
This process can seem daunting, but you don’t have to start it alone. Consider working with a doctor or registered dietitian to make a plan that works for you. And start small — choose a few changes to make gradually rather than overhauling your lifestyle all at once.
Stay active
Physical activity is important for overall health, weight regulation, and cholesterol levels.
A 2019 research review suggests that regularly getting vigorous exercise helps HDL clear LDL from the body more effectively. In general, adults should aim for
This can look like anything you enjoy doing, but some of the following can help you add exercise to your daily routine:
- Try biking to work.
- Take brisk walks with your dog.
- Swim laps at the local pool.
- Join a gym and go with a friend.
- Work in your yard or garden more often.
If you smoke, quit smoking
Smoking lowers your “good” cholesterol levels and raises your triglycerides. Even if you don’t already have hyperlipidemia, smoking can increase your risk of heart disease.
A doctor can help you understand smoking cessation options and which one may be right for you.
If lifestyle changes aren’t enough to manage your hyperlipidemia, your doctor may prescribe medication.
These medications can work in a variety of ways. For example, some block an enzyme the body needs to make cholesterol, while others keep your intestines from absorbing cholesterol.
Common cholesterol- and triglyceride-lowering medications include:
- statins, such as:
- bile acid sequestrants, such as:
- cholestyramine (Prevalite)
- colesevelam (Welchol)
- colestipol (Colestid)
- cholesterol absorption inhibitors, such as ezetimibe (Zetia)
- injectable alternatives to statins, such as alirocumab (Praluent) or evolocumab (Repatha)
- fibrates, like fenofibrate (Lipofen) or gemfibrozil (Lopid)
Some medications, like alirocumab, are approved by the Food and Drug Administration (FDA) specifically for inherited types of hyperlipidemia and can significantly lower LDL and the risk of cardiovascular events.
Others may be able to treat both familial and acquired hyperlipidemia, on their own or in combination with another drug.
The lifestyle changes that help manage hyperlipidemia can also help lower your risk of developing it. Eat a balanced diet, be physically active on a regular basis, and manage any other underlying conditions, like diabetes.
It’s best to get cholesterol screenings as recommended by a doctor and start developing healthy habits as soon as possible in life, particularly if you have a genetic risk for hyperlipidemia.
If you have access to them, healthcare professionals like cardiologists and registered dietitians can be very helpful additions to a cholesterol management team.
People with unmanaged hyperlipidemia have a much higher risk of developing conditions like coronary artery disease, stroke, heart attack, and other serious complications.
Hyperlipidemia is very treatable, however, and complications can often be avoided. Talk with a doctor to learn more about your possible risks and how you can start making changes to protect your health.