Dyslipidemian

Dyslipidemian, commonly referred to as dyslipidemia, is a medical condition characterized by abnormal levels of lipids in the blood. It includes elevated low-density lipoprotein cholesterol (LDL-C), elevated triglycerides, low high-density lipoprotein cholesterol (HDL-C), or combinations of these abnormalities. Dyslipidemia can be primary, due to genetic factors, or secondary, resulting from other diseases, medications, or lifestyle factors.

Common patterns include hypercholesterolemia (high LDL-C), hypertriglyceridemia (high triglycerides), and mixed dyslipidemia (a combination of high LDL-C and triglycerides with low HDL-C). Genetic forms include familial hypercholesterolemia and other polygenic conditions. Secondary causes encompass obesity and insulin resistance, diabetes mellitus, hypothyroidism, chronic kidney or liver disease, nephrotic syndrome, pregnancy, and medications such as steroids or certain antiretroviral therapies.

Diagnosis is based on a fasting lipid panel that measures total cholesterol, LDL-C, HDL-C, and triglycerides. Non-HDL cholesterol and apolipoprotein B can provide additional risk information. Many individuals with dyslipidemia are asymptomatic; signs such as xanthomas or corneal arcus may appear in some genetic forms or severe disease and signal higher cardiovascular risk.

Management focuses on reducing cardiovascular risk through lifestyle modification and, when appropriate, medication. Lifestyle recommendations include a heart-healthy diet, regular physical activity, weight management, and avoidance of tobacco. First-line pharmacotherapy for elevated LDL-C is a statin; alternatives include ezetimibe, bempedoic acid, and PCSK9 inhibitors. For elevated triglycerides, fibrates or prescription omega-3 fatty acids may be used, particularly at higher triglyceride levels. Treating underlying conditions can also improve lipid levels.

Prognosis depends on the lipid pattern and overall cardiovascular risk. Dyslipidemia is a major, modifiable risk factor for atherosclerotic cardiovascular disease, and appropriate screening and treatment can reduce long-term risk. Regular monitoring and risk reassessment are integral to management.