Hyperlipidemia (HLD) is the clinical term for an imbalance of LDL (“bad”) cholesterol, HDL (“good”) cholesterol, and triglycerides. These are blood fats (lipids) that are important to cellular health and metabolism at normal levels.

However, they can raise the risk of heart attack and other cardiovascular problems when levels of LDL and triglycerides get too high and HDL levels sink too low.

Even though HLD is a potentially serious threat to your health, there are usually few if any symptoms. HLD can be identified in a simple blood test before any complications develop. Once it’s diagnosed, a combination of medications and healthy lifestyle adjustments can often bring your levels of LDL cholesterol and triglycerides into a normal range.

HLD refers to having an imbalance of the cholesterol levels in your blood that can lead to serious heart conditions.

Cholesterol is measured in milligrams per deciliter (mg/dL) of blood. You want to keep LDL and triglyceride levels low, while HDL levels are healthier if they’re higher.

This is because LDL contributes to atherosclerosis, a narrowing of your arteries caused by plaque buildup. Plaques that form along your arterial walls are made up of cholesterol, fats, and other substances. More plaque means your arteries are less flexible and that blood flow is reduced.

That’s why LDL cholesterol is called the “bad” cholesterol. HDL cholesterol helps remove LDL cholesterol from the bloodstream, so it’s nicknamed the “good” cholesterol.

A 2016 study suggests that one of the big threats triglycerides pose to your vascular health is that elevated levels can contribute to inflammation that damages the blood vessels.

Terms to know

Discussions around heart health can become a bit of an alphabet soup, so here are a few quick definitions to keep at hand.

Essentially, you want to keep your HDL high and your LDL low.

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While there’s no specific number or set of numbers that define HLD, a measurement called total cholesterol is often used to determine when an individual is at particularly high risk of complications.

Total cholesterol is computed by adding your LDL and HDL levels, plus 20% of your triglyceride levels. A borderline high or high total cholesterol level suggests hyperlipidemia.

The National Institutes of Health (NIH) uses the following readings to determine when lipid levels are becoming concerning:

LDLBorderline high:
130 to 159 mg/dL
160 to 189 mg/dL
TriglyceridesBorderline high:
150 to 199 mg/dL
200 mg/dL or higher
HDLBorderline low:
60 mg/dL
less than 40 mg/dL
Total cholesterolBorderline high:
200 to 239 mg/dL
240 mg/dL and higher

The Centers for Disease Control and Prevention (CDC) reports that about 94 million Americans have total cholesterol levels higher than 200 mg/dL.

HLD can be an inherited condition, though certain lifestyle behaviors may also contribute to high cholesterol. Those factors include:

  • sedentary lifestyle
  • smoking
  • unbalanced diet, especially one rich in saturated fats and dietary cholesterol
  • obesity

HLD itself doesn’t have noticeable symptoms. However, a type of HLD — called HTG or abnormally high levels of triglycerides — is a major contributor to pancreatitis, the painful inflammation of your pancreas. A 2019 study suggests that the pancreatitis-associated risk of severe health problems and mortality is significantly higher in people with HTG and diabetes.

HLD can also cause atherosclerosis. While it doesn’t cause any noticeable symptoms either, it’s a major risk factor for:

Before a major event occurs, reduced blood flow in your arteries can cause pain. For example, when the heart muscle becomes starved of a sufficient flow of oxygenated blood, the chest pain that results is known as angina.

PAD occurs when blood flow is decreased in the extremities — usually your lower legs. The main symptoms include pain when walking or standing for too long. This is called claudication, and it usually subsides with rest. HLD could be connected to these symptoms as well.

A 2019 article suggests that HLD should always be considered a lifelong risk factor for atherosclerotic cardiovascular disease, and treatment should begin at the earliest signs of HLD, not later on when substantial plaque buildup has already taken place.

When to call your doctor

When atherosclerosis affects the arteries delivering blood to your heart muscle, you run the risk of a heart attack. When plaques form in the arteries carrying blood to your brain, you face a higher risk of stroke.

It’s important to know the signs of a heart attack or stroke, both of which should be considered medical emergencies and should prompt a call to 911 or local emergency services.

The common signs of a heart attack are:

Symptoms of a stroke may include:

  • difficulty communicating or understanding what’s being said to you
  • feeling numbness or tingling on one side of your body or face
  • sudden, severe headache
  • trouble with coordination and walking

It’s especially important to take heart attack and stroke symptoms seriously, especially if you have any of the following risk factors:

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While the risks posed by cholesterol imbalances can be reason for concern, there are also several things you can do to adjust your cholesterol levels at home and with a doctor. Some of the main treatment options include:

  1. Build healthy eating habits: One of the first things to do when trying to lower your LDL cholesterol and triglycerides is to adopt a heart-healthy diet. The American Heart Association recommends limiting saturated fats to no more than 6% of your daily calories. You should also try to incorporate more fruits and vegetables into your diet, as well as more lean proteins and whole grains.
  2. Create an exercise routine: Exercise is also important. Aim for 150 minutes per week of moderate-intensity exercise, ideally spread across most days of the week, rather than all on 1 or 2 days. If you’re overweight or obese, losing weight may help you get your cholesterol levels and blood pressure to healthy ranges.
  3. Avoid tobacco products: Quitting smoking or reducing the amount that you smoke is also critical, as it can contribute to plaque buildup and other health problems.
  4. Consider medications: Finally, a doctor may prescribe cholesterol-lowering medications, such as statins. There are seven types of statin available in the United States. Each one works a little differently, but they all affect the production of cholesterol in the liver and are usually well tolerated and effective at bringing down LDL levels. Statins can sometimes positively affect triglyceride and HDL levels, too.

How long does it take to change cholesterol levels?

Lowering cholesterol levels through diet and exercise alone may take 3 to 6 months with consistent effort. With a statin, it’s possible to get your LDL levels into a healthy range within about 6 weeks.

It’s important to note, however, that statins can have side effects, and the first statin you try may not be the right one. You may need to try more than one and adjust the dosage along the way before finding the right medication at the right strength to keep your cholesterol levels in the right place.

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HLD is a major risk factor for cardiovascular disease. The condition can be present without you knowing about it, as it frequently presents no symptoms. That’s why it’s important to work with a doctor and have your cholesterol levels checked annually or more frequently if your doctor recommends it.

If you can keep your cholesterol levels in a normal range, you may be able to avoid symptoms such as angina or claudication, or more serious complications such as a heart attack or stroke.