From the Guidelines
Dyslipidemia is a condition characterized by abnormal levels of lipids in the blood, requiring management through pharmacological and lifestyle interventions to reduce the risk of cardiovascular events, as outlined in the 2020 ESC guidelines 1. Dyslipidemia can manifest as high levels of total cholesterol, low-density lipoprotein (LDL or "bad" cholesterol), triglycerides, or low levels of high-density lipoprotein (HDL or "good" cholesterol). Key aspects of dyslipidemia management include:
- Lowering LDL-C to <1.4 mmol/L (<55 mg/dL) and reducing it by at least 50% if the baseline LDL-C level is 1.8-3.5 mmol/L (70-135 mg/dL) 1
- Considering statin treatment for patients with established CAD, irrespective of LDL-C levels 1
- Adding ezetimibe when the target LDL-C level cannot be achieved, as it has been shown to decrease cholesterol and cardiovascular events in post-ACS patients and in patients with diabetes 1 Management typically involves lifestyle modifications like adopting a heart-healthy diet, regular physical activity, weight management, and smoking cessation. For many patients, medications such as statins, ezetimibe, PCSK9 inhibitors, or fibrates may be necessary to achieve target lipid levels. The specific treatment approach depends on the type of lipid abnormality, cardiovascular risk factors, and individual patient characteristics. Regular monitoring of lipid levels is essential to assess treatment effectiveness and adjust therapy as needed.
From the Research
Definition of Dyslipidemia
- Dyslipidemia refers to an abnormal level of lipids in the blood, which can increase the risk of cardiovascular disease 2, 3, 4, 5, 6.
- It is characterized by high levels of low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (non-HDL) cholesterol, and triglycerides, and low levels of high-density lipoprotein (HDL) cholesterol.
Causes and Risk Factors
- Dyslipidemia can be caused by a combination of genetic and environmental factors, including diet, lifestyle, and certain medical conditions 2, 3, 4, 5, 6.
- Risk factors for dyslipidemia include a family history of the condition, obesity, physical inactivity, smoking, and a diet high in saturated and trans fats.
Treatment and Management
- The primary goal of treating dyslipidemia is to reduce the risk of cardiovascular disease by lowering LDL cholesterol and triglyceride levels, and increasing HDL cholesterol levels 2, 3, 4, 5, 6.
- Treatment options include lifestyle modifications, such as diet and exercise, and medication, such as statins and ezetimibe.
- Statins are the first-line therapy for dyslipidemia, and ezetimibe can be used in combination with statins to provide additional lipid-lowering effects 2, 3, 4, 5, 6.