Dyslipidemia Diagnosed and Treated in Baltimore

Dyslipidemia is an abnormality in the amounts of lipids and lipoproteins in the blood. These are usually simply called “blood cholesterol levels.” Total blood cholesterol that is too high increases the risk of cardiovascular diseases such as atherosclerosis, heart attack and stroke.

The body uses cholesterol to protect nerves, make cell tissue and produce certain hormones. Most cholesterol in the body is made by the liver, and more comes from the food you eat.

Risk factors for dyslipidemia include:

• Unhealthy diet
• Overweight or obesity
• Lack of exercise
• Family history of dyslipidemia or atherosclerosis
• High blood pressure
• Certain conditions: diabetes, hypothyroidism, kidney disease, polycystic ovary syndrome
• Some medications: certain birth control pills, beta-blockers, some antidepressants
• Smoking

Dyslipidemia can develop over a long period of time without any symptoms. Most people are not aware that they have a high cholesterol level until it is found during a routine physical exam. Blood cholesterol levels rise somewhat as people age. Cholesterol levels are a bit higher for men, but also increase in women after menopause.

Total blood cholesterol is composed of the following parts:

• LDL (low density lipoprotein):  the “bad” cholesterol - LDL is the type of protein found in plaque deposits
• HDL (high density lipoprotein): the “good” cholesterol – HDL removes  some cholesterol from the blood
• Triglycerides: the role of triglycerides is less clear, but lower values are better

A blood test will show the levels of the different parts of the total blood cholesterol. Cholesterol testing should occur on a regular basis beginning in early middle age. These are the current guidelines for blood cholesterol levels:

• Total cholesterol:    
  • less than 200 is good
  • 200-239 is borderline high
  • 240 or more indicates increased risk of cardiovascular disease
• LDL:
  • less than 100 is ideal
  • 100-129 is good
  • 130-159 is borderline high
  • 160 or more indicates increased  risk of cardiovascular disease
• HDL:
  • less than 40 indicates increased risk of cardiovascular disease
  • 60 or more indicates reduced risk of cardiovascular disease
• Triglycerides:
  • less than 150 is best

Lifestyle changes can have a good effect on total cholesterol levels and reduce the risk of disease. Sometimes these changes are enough to get blood cholesterol numbers back into their normal ranges, and no other treatment is necessary. Lifestyle changes can include:

• Regular exercise plan
• Heart-healthy diet
• Stop smoking
• Lose weight if overweight or obese

When lifestyle adjustments aren’t enough, medications can be prescribed:

• Statins (HMG-CoA reductase inhibitors)
• Resins (bile acid sequestrants)
• Cholesterol (absorption inhibitors)
• Fibrates (fibric acid derivatives)
• Niacin (B vitamin)