dyslipidemia

Dyslipidemia is a group of conditions characterized by abnormal levels of lipids in the blood, including elevated low-density lipoprotein (LDL) cholesterol, elevated triglycerides, low high-density lipoprotein (HDL) cholesterol, or a combination of these. It is a major risk factor for atherosclerotic cardiovascular disease, including heart attack and stroke.

Dyslipidemia can be primary (genetic) or secondary to other conditions or factors. Common primary disorders include familial hypercholesterolemia and familial combined hyperlipidemia. Secondary causes include obesity, type 2 diabetes, hypothyroidism, kidney or liver disease, certain medications, and poor dietary habits. Patterns include hypercholesterolemia (high LDL-C), hypertriglyceridemia (high TGs), low HDL-C, or mixed dyslipidemia.

Diagnosis is based on a lipid panel measuring total cholesterol, LDL-C, HDL-C, and triglycerides. Calculations such as non-HDL cholesterol or apoB may be used in some cases. Risk assessment for atherosclerotic cardiovascular disease guides treatment decisions, with emphasis on LDL-C as a primary target in most guidelines.

Management begins with lifestyle modification, including a heart-healthy diet, regular exercise, weight control, and smoking cessation. Pharmacologic treatment commonly starts with statins to lower LDL-C, with ezetimibe, PCSK9 inhibitors, or newer agents as add-ons or alternatives in certain patients. For high triglycerides, fibrates or prescription-strength omega-3 fatty acids may be used, and treatment of secondary causes is also important. Niacin is less commonly used due to side effects and limited incremental benefit.

Dyslipidemia is generally a long-term condition requiring periodic lipid monitoring and risk-based treatment to reduce cardiovascular events. Guidelines vary by region, but the emphasis is on lowering LDL-C and achieving individualized risk reduction.