Elevation of total cholesterol (TC) and/or LDL-cholesterol or non-HDL-cholesterol (defined as the subtraction of HDL-cholesterol from total cholesterol) in the blood, is also often referred to as dyslipidemia, to encompass the fact that it might be accompanied by a decrease in HDL-cholesterol or an increase in triglycerides.
Usually symptomatically quiescent until significant degrees of atherosclerosis have occurred.
Complications include MI, ischemic cardiomyopathy, sudden death, stroke, erectile dysfunction, peripheral vascular disease, and acute limb ischemia.
Risk factors for secondary hypercholesterolemia in industrialized populations include a sedentary lifestyle and a diet characterized by the excessive consumption of saturated fats, trans-fatty acids, and cholesterol. Other causes include diabetes, excess body weight mainly in abdominal region, hypothyroidism, nephrotic syndrome, and cholestatic liver disease. Low HDL-cholesterol levels are associated with smoking and abdominal obesity.
Diagnosed by fasting lipid profile, consisting of measurements of total cholesterol, LDL (estimated or direct), HDL, and triglycerides.
Treated with lifestyle modifications such as dietary changes and exercise, as well as pharmacologic intervention with statin therapy, niacin, bile acid sequestrants, or cholesterol absorption inhibitors (ezetimibe).
Xanthomata over the metacarpophalangeal joints
Center for Preventive Cardiology, University of Maryland Medical Center