Hyperlipidemia may be classified according
to which type of lipids are elevated (e.g., hypertriglyceridemia). More
commonly though, hyperlipidemia is classified as primary (or familial) or secondary
- Primary hyperlipidemia is
caused by specific genetic abnormalities and may be inherited
- Secondary hyperlipidemia is
caused by other medical conditions. The most important secondary causes of
Sedentary lifestyle with
excessive dietary intake of saturated fat, cholesterol, and trans fats
o Alcohol overuse
o Chronic kidney disease e.g. nephrotic syndrome, renal failureo Hypothyroidismo Primary biliary cirrhosis and other cholestatic liver diseases
o Drugs, such as thiazides, beta-blockers, retinoids, highly active antiretroviral agents, cyclosporine, tacrolimus, estrogen and progestins (birth control pills), and glucocorticoids (steroids)
Hyperlipidemia usually has no symptoms.
Very high hyperlipidemia can cause the
- Shortness of breath and
- Arcus corneae
- Tendinous xanthoma
- Xanthelasma (lipid rich yellow
plaques on the medial eyelids). Xanthelasma can also occur in patients with
primary biliary cirrhosis and normal lipid levels.
- Tuberous xanthomas (painless,
firm nodules typically located over extensor surfaces of joints)
- Lipemia retinalis (retinal
arteries and veins have a creamy white appearance)
Diagnosis of hyperlipidemia is by blood
test (measuring plasma levels of total cholesterol, TG, HDL cholesterol, and
For most patients with newly diagnosed
hyperlipidemia, tests for secondary causes of hyperlipidemia should be done. Tests
- Liver enzymes
- Thyroid-stimulating hormone
- Urinary protein
For those without a prior heart attack or
stroke, the 10-year risk of heart disease or stroke may be calculated using the
Atherosclerotic Cardiovascular Disease (ASCVD) algorithm, which provides a
useful reference point to assess future risk.
Cross Street Medical
offers all relevant hyperlipidemia screening tests. Speak to our doctors about what you may need.
Treatment options depend on the specific
lipid abnormality, although different lipid abnormalities often coexist.
Hyperlipidemia is usually treated with
oral lipid-lowering medication such as statins.
Lipid measurement should be accompanied by
assessment for other cardiovascular risk factors, including:
- Diabetes mellitus
- Cigarette use
- Family history of coronary
artery disease (CAD) in a male 1st-degree relative before age 55 or a female
1st-degree relative before age 65
Treatment of hyperlipidemia should thus include
management of these risk factors. For instance, smoking cessation should be
In general, treatment options for men and
women are the same.
Cross Street Medical
offers all relevant treatments for hyperlipidemia. Speak to our
doctors about what you may need.
Hyperlipidemia is a Medisave/CHAS
claimable chronic condition for eligible patients.