Hyperlipidemia (dyslipidemia) or elevated cholesterol, similar to hypertension, is often asymptomatic and is a major risk factor for cardiovascular disease and death. Unfortunately, more than 15% of US adults have hyperlipidemia. The current recommendation from the US Preventative Service Task Force is that men older than age 35 and women older than age 45 have routine while younger adults (Men and women over age 20) be screened if they have other risk factors for cardiovascular disease, heritable family cholesterol disorders or family histories of premature coronary heart disease. Screening is performed with a fasting blood test to identify total, low density (bad) and high density (good) cholesterol. Based on these results as well as an assessment of overall risk for atherosclerotic heart disease, treatment recommendations can be made. Initial therapy for hyperlipidemia includes lifestyle modifications. Diets can reduce LDL levels by as much as 15% and can dramatically reduce the need for medications. Similarly, exercise can improve one’s cholesterol profile. However, when diet and exercise alone are not enough, medications may be required. The most commonly used medications are the statins. However, there is evolving research on the effect of a new class of medications known as PCSK9 inhibitors to treat certain patients with hyperlipidemia.
Kopin L and Lowenstein C. In The Clinic: Dyslipidemia. Ann Intern Med. 2010 Aug 3; 153 (3)