What’s the Difference Between Hyperlipidemia and Hypercholesterolemia?

Hyperlipidemia is a condition where you have a high level of lipids (fats) in your blood. Specifically, with hyperlipidemia, you have high levels of the following types of lipids:

• Low-density lipoprotein (LDL) cholesterol. LDL cholesterol is often referred to as the “bad” cholesterol. It plays a key role in the buildup of fatty deposits in arteries, causing them to narrow (atherosclerosis).
• Triglycerides. When you take in more calories than you burn, your body converts the excess calories into triglycerides, a type of fat. Having high triglyceride levels plus high LDL may increase the risk of plaque buildup in your arteries.

Hyperlipidemia is a common condition. It’s estimated that 50 percent of Americans have hyperlipidemia in some form.

What’s considered a high level of cholesterol and triglycerides?

A blood test called a lipid panel, or a lipid profile, can determine your cholesterol and triglyceride levels. Levels are often measured in milligrams per deciliter (mg/dL).

According to the National Library of Medicine, your total cholesterol, LDL cholesterol, and triglycerides can be classified as follows:

Causes and risk factors of hyperlipidemia

Hyperlipidemia can be genetic, meaning it runs in families and is an inherited condition. This type of hyperlipidemia is called primary hyperlipidemia, or familial hyperlipidemia.

But hyperlipidemia is more often the result of lifestyle factors, such as:

• an unbalanced diet, especially one that’s high in saturated fat
• too little physical activity
• having overweight or obesity
• smoking
• heavy alcohol use

Other factors that can put you at an increased risk of hyperlipidemia, even if you don’t have other risk factors, include:

• your age — males over age 45 and females over age 55 have a higher risk of developing hyperlipidemia
• taking certain medications, including:
  • birth control pills
  • beta-blockers
  • some antidepressants
• having an underlying health condition, such as:
  • diabetes
  • an underactive thyroid
  • liver disease
  • kidney disease

Hypercholesterolemia is a specific type of hyperlipidemia. With hypercholesterolemia, you either have too much LDL cholesterol or too little high-density lipoprotein (HDL) cholesterol in your blood.

High-density lipoprotein (HDL) cholesterol is also known as “good” cholesterol. This healthy type of cholesterol helps to remove LDL cholesterol — the “bad“ type — from your arteries. Because HDL cholesterol plays an important role in getting rid of LDL, you want higher levels of HDL in your blood.

The risk factors, potential causes, and possible health impacts are the same for hypercholesterolemia as they are for hyperlipidemia.

What’s considered a healthy level of HDL cholesterol?

A desirable level of HDL cholesterol is considered to be 60 mg/dL or above. A level of 40 mg/dL or lower (for males) and 50 mg/dL or lower (for females) is considered to put you at a higher risk of a heart attack and stroke.

Hypercholesterolemia is a type of hyperlipidemia. In other words, hyperlipidemia is an umbrella term. Various inherited or acquired disorders that cause high lipid levels in the blood fall under this umbrella category.

The key differences between hyperlipidemia and hypercholesterolemia can be summarized as follows:

Neither hyperlipidemia nor hypercholesterolemia cause symptoms in most people. That’s one reason why it’s important to get your cholesterol and triglyceride levels checked on a regular basis.

Your doctor may order a blood test called a lipid panel to check your lipid levels if you have certain risk factors or if you have a family history of either condition.

These tests are also often part of routine care after you reach a certain age — usually 35 years old for males and 45 years old for females, unless you have other risk factors.

You may need to fast for 9 to 12 hours before your blood test to get an accurate reading.

For many people with hyperlipidemia or hypercholesterolemia, lifestyle changes are enough to help manage their condition.

Lifestyle changes that may help reduce lipid or cholesterol levels include:

• Reducing your intake of saturated fat and trans fat; this may include eating less:
  • red meat
  • whole milk dairy products
  • fried foods
  • processed foods
• Eating more vegetables, fruits, whole grains, fish, skinless poultry, nuts, and seeds.
• Exercising regularly. Aiming for at least 150 minutes of moderate-intensity exercise each week can help reap the most health benefits.
• Losing weight if you have overweight or obesity.
• Quitting smoking, if you smoke.
• Cutting back on your alcohol intake.

If lifestyle changes aren’t enough to reduce your lipid or cholesterol levels, your doctor may consider prescribing medications as well.

Medications that may help manage hyperlipidemia or hypercholesterolemia include:

• statins, such as:
  • simvastatin (Zocor)
  • atorvastatin (Lipitor)
  • rosuvastatin (Crestor)
  • pravastatin (Pravachol)
• bile acid binding resins, such as:
  • colesevelam (Welchol)
  • cholestyramine (Prevalite, Questran)
  • colestipol (Colestid)
• PCSK9 inhibitors, which are taken as an injection
• niacin
• fibrates
• omega-3 fatty acid supplements

If left untreated, hyperlipidemia and hypercholesterolemia can both lead to serious health complications, including:

• atherosclerosis (narrowing of the arteries)
• stroke
• heart attack
• high blood pressure
• type 2 diabetes
• peripheral artery disease
• coronary artery disease

Hyperlipidemia is an umbrella term that includes various disorders that cause high lipid levels in the blood. Hypercholesterolemia is a type of hyperlipidemia that involves above normal levels of cholesterol in the blood.

By maintaining a moderate weight, eating a balanced diet, and exercising regularly, you may be able to help keep both cholesterol and other blood lipids under control and reduce your risk of a heart attack or stroke.

If you have any risk factors for either hyperlipidemia or hypercholesterolemia, talk with a doctor about getting your lipid levels checked.