Dyslipidemia

Dyslipidemia is the medical name for cholesterol problems - sometimes (although not accurately) called "high cholesterol". Strictly speaking, dyslipidemia is a disorder of metabolism related to lipoprotein. Although called a disorder, it is extremely common in modern society. Dyslipidemia is when the blood test indicates high total cholesterol, high LDL "bad cholesterol", or low HDL "good cholesterol". Another word for Dyslipidemia is Hyperlipidemia.

The measurement is done in the plasma portion of the blood. Plasma is the liquid part of the blood, without the red and white cells. You sometimes hear the number called plasma cholesterol or serum cholesterol.

There is no firm number indicating dyslipidemia. If treatment is subjectively deemed to be beneficial, the patient can be said to have dyslipidemia. Treatment options include changes in diet, changes in exercise routines, and medications. Statins are among the medications used to affect dyslipidemia. Other drugs include fibric acids, nicotinic acid, and bile acid sequestrants.

What is high cholesterol and what is normal? Mother Nature has made no firm dividing mark. The medical community has identified certain norms and individual doctors make judgement calls. There is certainly a relationship between lipid levels and risk for heart disease. Even people with normal cholesterol can benefit from statins, which is one reason some advocate wider usage.

When you have your blood taken and a lipid profile done at the doctor's office, they usually measure total cholesterol (TC), high-density cholesterol (HDL), low-density cholesterol (LDL), and triglycerides.

A more precise division breaks down blood (plasma) lipoproteins into five major families:

  • chylomicrons
  • very low-density lipoproteins (VLDL)
  • intermediate-density lipoproteins (IDL)
  • low-density lipoproteins (LDL)
  • high-density lipoproteins (HDL)

Statins reduce triglyceride levels about 10% to 20%. The higher the triglyrceride level, the more the percentage effect. Statins tend to be highly effective in lowering TC and LDL but the increase of HDL is modest.

Reliable data for a universally accepted method for the monitoring of lipid-lowering therapy is not available. The federal government's Adult Treatment Panel recommends monitoring of the LDL-C at six week intervals after commencement of treatment pending the achievement of the LDL-C goal. 6 to 12 month measurements of patients that incorporate lifestyle changes are reasonable. Because cholesterol measurements have short-term variability and gradual long-term increases in LDL-C because of age, an additional analysis recommended the monitoring of lipid levels may be optimized by monitoring every three to five years with adherent patients with well controlled lipid levels.

There are different potential causes of cardiovascular disease; dyslipidemia is one of the biggest. Inflammation of the cardiovascular system is also a potential causes, and some researchers are increasingly looking to this source of problems as an explanation for why some people get heart attacks. Statins have an anti-inflammatory function.

Does high LDL "cause" cardiovascular disease? Or is it more appropriately called a "risk factor"? While decades ago the more amorphous "risk factor" may have been an appropriate description, science has found such strong connections that the word "cause" is probably appropriate.

A Note on Metabolic Syndrome

Metabolic syndrome a catch-all term used to describe a person with three or more of the following:

  • high blood pressure
  • high blood sugar level
  • obesity, especially with fat deposits around the abdomen, where men tend to accumulate fat
  • high triglyceride level in the blood
  • low level of HDL (good cholesterol)

Can the polypill address metabolic syndrome?

National Heart, Blood, and Lung Institute on metabolic syndrome

Progress in dyslipidemia.



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