Hyperlipidæmi

Hyperlipidæmi is a condition characterized by elevated levels of lipids in the blood, most often cholesterol and triglycerides. It includes genetic disorders such as familial hypercholesterolaemia and familial combined hyperlipidaemia (primary hyperlipidæmias) as well as conditions caused or worsened by secondary factors such as obesity, diabetes mellitus, hypothyroidism, nephrotic syndrome, alcohol use, and certain medications. Lipoproteins most implicated are low-density lipoprotein (LDL) and triglyceride-rich remnants; high-density lipoprotein (HDL) levels may be normal or reduced.

Diagnosis relies on lipid panels that measure total cholesterol, LDL-C, HDL-C, and triglycerides, interpreted with regard to overall cardiovascular risk. Many individuals are asymptomatic; physical signs such as xanthomas or corneal arcus may appear in familial forms. Very high triglycerides can cause pancreatitis.

Management centers on reducing cardiovascular risk through lifestyle modification and pharmacotherapy. Lifestyle measures include weight loss, regular physical activity, and dietary changes to reduce saturated fats and refined carbohydrates, increase fiber, and limit alcohol. Statins are the first-line medications to lower LDL-C and ASCVD risk. When targets are not reached or in certain patients, ezetimibe, PCSK9 inhibitors, or bempedoic acid may be added. Fibrates or high-dose omega-3 fatty acids are used to treat severe hypertriglyceridaemia. Treatment of secondary causes is essential, and emerging therapies may target lipoprotein(a) in selected cases. Regular monitoring of lipid levels and liver enzymes is recommended to assess response and safety.