Dyslipidemia, or abnormal levels of fat in the blood, and more specifically hypercholesterolemia are omnipresent in the global population.
Gradually blocking the arteries, these conditions contribute to the development of several cardiovascular diseases.
Their treatment, prevention or cure involves modifying behaviors, combined, if necessary, with pharmacological treatments.
Dyslipidemia refers to abnormal serum lipid concentrations, characterized by high levels of “bad” cholesterol (LDL-c hypercholesterolemia), triglycerides (hypertriglyceridemia) or both (mixed hyperlipidemia). Low levels of “good” cholesterol (HDL-c) may also be present.
adult has dyslipidemia, according to WHO: 62% versus 53.7% in Europe, and 47.7% in the United States.
million deaths per year.
million years of healthy life lost.
Some dyslipidemias, known as primary dyslipidemias, may be linked to genetic mutations leading to the irregular production and/or elimination of triglycerides, LDL-c or HDL-c.
However, the majority of dyslipidemias are linked to external factors: a sedentary lifestyle combined with an excessive intake of saturated fats, cholesterol and trans fatty acids. People with overweight or obesity are thus among the most likely to be affected by these conditions.
Other extrinsic factors may also contribute, such as a pathology (diabetes, a kidney, liver or thyroid condition, etc.) or a treatment (oral contraceptive, beta blocker, glucocorticoid, etc.).
Dyslipidemias cause fat deposits to form along the artery walls (atheroma plaques), which ultimately causes the arteries to become narrow or even clogged. Atherosclerosis can lead to various cardiovascular conditions: acute coronary syndromes, cerebralvascular accidents (CVAs), transient ischaemic attacks (TIAs) or even peripheral artery disease (PAD).
Dyslipidemia presents no visible symptoms, with physical manifestations often appearing only once the arteries are affected, at which point swift intervention is required.
Given how common cholesterol problems are, regular physical assessments are recommended for at-risk people (ill or overweight).
In the absence of cardiovascular risk factors, the total cholesterol should be below 2 g/L, with HDL-c above 0.40 g/L, LDL-c below 1.60 g/L, and triglycerides below 1.50 g/L. In case of cardiovascular risk, the therapeutic objective determines the maximum level of LDL-c expected (1.30 g/L, or lower).
The primary objective when treating dyslipidemia is to lower LDL-c or triglyceride levels. For this reason, the primary risk factors should be adjusted, by making dietary changes, engaging in physical exercise and losing weight.
A medicinal treatment, prescribed by a healthcare professional, may also be used to help control the levels of circulating lipids, either directly in the case of primary dyslipidemia or by addressing the cause in the case of secondary dyslipidemia.