What is the difference between hyperlipidemia and hypercholesterolemia?

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Last updated: April 14, 2025View editorial policy

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From the Guidelines

Hyperlipidemia is a broader condition that encompasses elevated levels of any lipids in the blood, including cholesterol, triglycerides, or both, whereas hypercholesterolemia specifically refers to high blood cholesterol levels only. The distinction between these two conditions is crucial for determining the appropriate treatment approach, as highlighted in the 2016 ESC/EAS guidelines for the management of dyslipidaemias 1. According to these guidelines, LDL-Cholesterol (LDL-C) should be used as the primary lipid analysis for screening, risk estimation, diagnosis, and management.

Key differences between hyperlipidemia and hypercholesterolemia include:

  • Hyperlipidemia can refer to elevated levels of triglycerides, cholesterol, or both, while hypercholesterolemia is specifically concerned with high cholesterol levels.
  • Treatment approaches may vary depending on which lipid components are elevated, with statins being first-line for hypercholesterolemia 1 and fibrates might be preferred for isolated hypertriglyceridemia.
  • The 2016 ESC/EAS guidelines recommend targeting LDL-C levels, with specific goals for patients at very high CV risk (< 1.8 mmol/L or a reduction of at least 50% if the baseline LDL-C is between 1.8 and 3.5 mmol/L) and high CV risk (< 2.6 mmol/L or a reduction of at least 50% if the baseline LDL-C is between 2.6 and 5.1 mmol/L) 1.

In clinical practice, it is essential to accurately diagnose and manage both hyperlipidemia and hypercholesterolemia to reduce cardiovascular risk, as both conditions can increase the likelihood of cardiovascular events. The use of statins, ezetimibe, PCSK9 inhibitors, or fibrates may be necessary, depending on the specific lipid profile and cardiovascular risk factors of the patient 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Definition and Difference

  • Hyperlipidemia refers to an elevation of one or more of the various types of lipids (fats) in the bloodstream, including cholesterol and triglycerides 2.
  • Hypercholesterolemia, on the other hand, is a specific type of hyperlipidemia characterized by high levels of low-density lipoprotein cholesterol (LDL-C) in the blood 3, 4.

Risk Factors and Complications

  • Both hyperlipidemia and hypercholesterolemia increase the risk of developing cardiovascular disease (CVD), with hypercholesterolemia being a major risk factor for CVD 2, 5.
  • Familial hypercholesterolemia (FH) is a genetic disorder that leads to very high levels of LDL-C and significantly increases the risk of premature CVD 2, 3.

Treatment Options

  • Statins are the primary treatment for hyperlipidemia and hypercholesterolemia, but may not be sufficient for all patients, particularly those with FH or statin intolerance 2, 4, 5.
  • Additional treatment options, such as ezetimibe, PCSK9 inhibitors, and bile acid sequestrants, may be necessary to achieve optimal lipid levels and reduce CVD risk 2, 3, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Epidemiology and management of hyperlipidemia.

The American journal of managed care, 2017

Research

A Comprehensive Review of PCSK9 Inhibitors.

Journal of cardiovascular pharmacology and therapeutics, 2022

Research

Defining the Role of PCSK9 Inhibitors in the Treatment of Hyperlipidemia.

American journal of cardiovascular drugs : drugs, devices, and other interventions, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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