From the Guidelines
Secondary dyslipidemias are abnormal blood lipid levels that occur as a result of underlying medical conditions, medications, or lifestyle factors rather than genetic causes, and their management should focus on treating the underlying condition while also addressing the lipid abnormalities. These disorders develop when another health issue disrupts normal lipid metabolism, leading to elevated cholesterol, triglycerides, or altered lipoprotein levels. Common causes include diabetes mellitus, as seen in the study 1, which highlights the importance of managing lipid levels in individuals with diabetes. Other causes include hypothyroidism, chronic kidney disease, liver disorders, and certain medications such as thiazide diuretics, beta-blockers, estrogens, glucocorticoids, and antiretroviral drugs. Excessive alcohol consumption and obesity can also trigger secondary dyslipidemias. Some key points to consider in managing secondary dyslipidemias include:
- Identifying and treating the underlying cause of the dyslipidemia
- Achieving better glycemic control in diabetes, as recommended in the study 1, which suggests limiting saturated fatty acids to 10% and preferably to 7% of energy intake
- Adjusting medication or lifestyle factors that may be contributing to the dyslipidemia
- Addressing lipid abnormalities through dietary changes, such as increasing viscous fiber and plant stanols/sterols, and physical activity, as outlined in the study 1
- Considering alternative medications if necessary, to minimize the risk of cardiovascular complications.
From the Research
Definition of Secondary Dyslipidemias
- Secondary dyslipidemias are caused by unhealthy lifestyle factors and acquired medical conditions, including underlying diseases and applied drugs 2.
- They account for approximately 30-40% of all dyslipidemias 2.
Causes of Secondary Dyslipidemias
- Excessive alcohol intake 3
- Uncontrolled diabetes mellitus 3
- Overt albuminuria 3
- Hypothyroidism 2
- Other medical conditions and drugs that interfere with lipid metabolism 2, 3
Importance of Identifying Secondary Dyslipidemias
- Identifying and addressing the underlying cause of secondary dyslipidemia is crucial for safe and effective treatment 2, 3.
- Failure to do so may lead to adverse events, such as myopathy and rhabdomyolysis 2.
- Nearly 1/3 of patients referred to a specialty clinic had identifiable secondary conditions plausibly contributing to their dyslipidemia 3.