dislipidemia

Dislipidemia, also known as dyslipidemia, refers to abnormal concentrations of lipids in the blood, most often involving low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. It is a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD). Most people are asymptomatic; diagnosis relies on lipid testing, usually a fasting lipid panel, with nonfasting samples acceptable in some settings. Categories are defined by guideline-specific thresholds, but elevated LDL-C, low HDL-C, or high triglycerides alone or in combination indicate dislipidemia.

Causes can be primary (genetic) or secondary to other conditions such as diabetes, obesity, hypothyroidism, kidney or liver disease, or certain medications. Familial hypercholesterolemia and other genetic disorders cause markedly elevated LDL-C and require specialized management.

Management emphasizes lifestyle modification and risk reduction. Dietary changes (reducing saturated fat and refined carbohydrates, increasing fruits, vegetables, and fiber), regular physical activity, weight management, and smoking cessation are first-line. Pharmacotherapy is used when cardiovascular risk is high or lipid levels remain above targets despite lifestyle changes. Statins are the mainstay; other options include ezetimibe, PCSK9 inhibitors, bile acid sequestrants, fibrates, and, in selected cases, niacin.

Monitoring includes periodic lipid panels to assess response and adherence, with adjustments for efficacy and tolerance. In severe hypertriglyceridemia, there is a risk of pancreatitis and urgent management.