Hyperlipidémiu

Hyperlipidémiu is a medical condition characterized by abnormally high levels of lipids, such as cholesterol and triglycerides, in the bloodstream. Elevated lipids can accumulate in arterial walls, contributing to the development of atherosclerosis and increasing the risk for cardiovascular events such as heart attack and stroke.

The condition can be inherited (familial hyperlipidemia) or acquired. Genetic variants in genes like LDLR, APOB, PCSK9, and APOE can impair the clearance of low‑density lipoprotein (LDL) particles. Acquired causes include dietary habits high in saturated fat, obesity, sedentary lifestyle, uncontrolled diabetes mellitus, hypothyroidism, chronic kidney disease, liver disorders, and certain medications such as glucocorticoids and beta‑blockers.

Patients may have no symptoms initially. When signs appear, they may include xanthomas, arcus cornealis, or, in severe cases, pancreatitis if triglycerides exceed 1000 mg/dL. Diagnosis involves fasting lipid panel measurements that report total cholesterol, LDL, high‑density lipoprotein (HDL), and triglycerides. Risk assessment tools like the ASCVD risk calculator help determine the need for pharmacologic therapy.

First‑line treatment focuses on lifestyle modifications: weight loss, regular aerobic activity, limiting saturated and trans fats, increasing dietary fiber, and limiting alcohol intake. Pharmacologic interventions start with statins, which inhibit HMG‑CoA reductase and reduce LDL synthesis. If LDL targets are not met, additional agents such as ezetimibe, PCSK9 inhibitors, or bile acid sequestrants can be added. For very high triglycerides, fibrates or omega‑3 fatty acid supplements may be prescribed.

Long‑term management includes regular monitoring of lipid levels, reassessment of cardiovascular risk, and adherence to therapy. Prevention relies on early dietary counseling, physical activity promotion, and screening in high‑risk families to mitigate progression to cardiovascular disease.