Lipercolesterolemia

Lipercolesterolemia is not a widely used or officially recognized medical term in major guidelines. In practice, conditions involving high blood cholesterol are described as hypercholesterolemia or dyslipidemias. If the term is encountered, it would typically refer to elevated levels of cholesterol carried by circulating lipoproteins, most notably low-density lipoprotein (LDL), which increases the risk of atherosclerotic cardiovascular disease (ASCVD).

Causes of a lipercholesterolemia-like state include genetic factors, such as familial hypercholesterolemia due to LDL receptor or ApoB mutations, and polygenic forms of hypercholesterolemia. Secondary factors include an unhealthy diet high in saturated fats, obesity, physical inactivity, diabetes, hypothyroidism, nephrotic syndrome, liver disease, and certain medications.

The pathophysiology involves LDL particles infiltrating arterial walls, becoming modified, and triggering inflammation that leads to plaque formation and arterial stenosis. The cardiovascular risk is influenced by the number and quality of LDL particles, as well as other lipids and inflammatory factors.

Clinical features may be absent in early stages. Physical signs, when present, can include xanthelasma or corneal arcus. Diagnosis relies on a lipid panel: total cholesterol, LDL-C, HDL-C, and triglycerides, interpreted in the context of age and ASCVD risk. In individuals with a family history suggestive of a hereditary form, genetic testing or cascade testing may be considered.

Management emphasizes lifestyle modification and pharmacotherapy. First-line treatment typically includes statins, with alternatives such as ezetimibe, PCSK9 inhibitors, bempedoic acid, or fibrates depending on the lipid pattern and comorbidities. Goals are individualized based on ASCVD risk.

Naming and classification: because lipercolesterolemia is not an established term, it is recommended to use standard terminology such as hypercholesterolemia or familial hypercholesterolemia for accuracy in clinical and educational contexts.