Hyperlipidemia & Coronary Heart Disease

  • Several factors can make patients more likely to develop hyperlipidemia, including a diet high in saturated fats and cholesterol; family history; being overweight or obese; and getting older. Too much cholesterol may lead to a buildup of plaque inside the arteries. Known as atherosclerosis, this condition narrows the space available for blood flow and can trigger heart disease.

  • Health-providers should test for hyperlipidemia by performing fasting lipoprotein profiles every five years among adults aged 20 years and older. Total cholesterol measures the combination of LDL, HDL, and very low-density lipoprotein in the bloodstream. A total cholesterol score lower than 200 is considered healthy in most cases.

  • Hyperlipidemia can cause fatty lumps under the skin, known as xanthoma. Xanthoma are sharply demarcated yellowish collection of cholesterol under the skin, that can occur anywhere on the body, but are most often seen on the elbows, joints, tendons, knees, hands, feet or buttocks.

  • Eating a low-fat, high-fiber diet and exercising can help lower cholesterol levels, but sometimes this may not be enough. Statins, which are drugs that block the production of cholesterol in the liver, are considered first-line medications to lower cholesterol. Other options include cholesterol absorption inhibitors, bile acid resins and fibrates.

  • Patients with uncontrolled hyperlipidemia who develop atherosclerosis and angina, may need a surgical procedure known as angioplasty. During angioplasty a catheter with a balloon at its tip is inserted into a blocked coronary artery and inflated to clear the artery and improve blood flow. Stents, like the one pictured here, can be inserted to expand and attach to the artery wall, supporting the inner artery wall and reducing the chance future narrowing or blockage.

  • Another option for patients with atherosclerosis and angina, is coronary artery bypass grafting (CABG), in which a healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the coronary artery. This computed tomography scan shows a double arterial and venous coronary bypass between the aorta and the anterior interventricular coronary artery, downstream from the stenosis.

  • But there is good news. Between 1988–1994 and 2005–2008, the percentage of the U.S. population with high cholesterol (defined240 mg/dL or higher) declined among all age groups, and is likely the result of improved awareness and increased use of cholesterol-lowering medications, according to the CDC.

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Approximately one in every six adults — 16.3% of the U.S. adult population— has hyperlipidemia, or high cholesterol. People with high cholesterol have approximately twice the risk for heart disease as people with lower levels, but many are unaware of their condition because there are no symptoms. Learn more about hyperlipidemia and coronary heart disease with this slideshow.

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