Lipids play an important role in human metabolism. They give energy to our cells, provide structure for cell membranes, help regulate hormones, and so much more. But some people’s lipid levels can become high enough to cause health complications, such as an increased risk of heart disease.

Hyperlipidemia, sometimes shortened as HLD, is an umbrella term for several health conditions that feature high levels of lipids in the blood. Hyperlipidemia affects roughly 3 million people in the United States and Europe alone, so it’s important to be aware of what this condition can look like.

Ahead, we’ll explore the various types of hyperlipidemia, including how doctors diagnose and treat it.

Before we dive into the different types of hyperlipidemia, it can be helpful to first understand the types of lipoproteins in the blood linked to hyperlipidemia. Lipoproteins are the proteins responsible for carrying lipids (fats) around your body.

  • Chylomicrons: Chylomicrons are responsible for transporting triglycerides and cholesterol to your liver and various tissues around your body.
  • Very low-density lipoproteins (VLDLs): Your liver creates VLDLs, which help transport triglycerides to different tissues.
  • Intermediate-density lipoproteins (IDLs): When muscle and fat tissues take triglycerides from VLDLs, they create IDLs. Because the triglyceride content of IDLs is lower, they contain more cholesterol.
  • Low-density lipoproteins (LDLs): When IDLs lose more triglycerides, they create LDLs. LDLs are extremely high in cholesterol and are responsible for carrying the majority of cholesterol in the body.
  • High-density lipoproteins (HDLs): HDLs are responsible for removing cholesterol from the tissues and transporting it to the liver.

Doctors classify the six types of hyperlipidemia based on which lipoproteins are elevated in the blood.

HLD typeCondition nameElevated lipoproteins
Ifamilial hyperchylomicronemia or primary hyperlipoproteinemiachylomicrons
IIafamilial hypercholesterolemia or polygenic hypercholesterolemiaLDL
IIbfamilial combined hyperlipidemia (FCHL)LDL, VLDL
IIIfamilial dysbetalipoproteinemiaIDL
IVfamilial hypertriglyceridemia (FHTG)VLDL
VhyperprebetalipoproteinemiaVLDL, chylomicrons

Hyperlipidemia can either be primary, which is caused by genetics, or secondary, which is caused by another underlying health condition. Type I HLD is the rarest form of hyperlipidemia. Type IIb (FCHL) is the most common form of the condition.

A physical examination, thorough review of family history, and routine bloodwork can all help screen for hyperlipidemia.

A physical examination can allow your doctor to check for any symptoms associated with hyperlipidemia, such as fat deposits, eye changes, and certain heart sounds.

A thorough review of your family history can help your doctor see if there are genetic risk factors to consider, such as having a close family member with hyperlipidemia.

A lipid profile, also known as a lipid panel or cholesterol test, is the most common blood test doctors use for screening and diagnosing hyperlipidemia. This routine blood test can give your doctor the following blood lipid levels:

  • total cholesterol
  • LDL
  • HDL
  • triglycerides

Your doctor can also find additional information within your lipid panel that may help diagnose hyperlipidemia, such as your VLDL levels, cholesterol/HDL ratio, and LDL/HDL ratio.

Some people with advanced FCHL may develop the following symptoms:

  • Xanthomas: Xanthomas are fat deposits that can appear under the skin or around the tendons. They appear as yellow, waxy, raised patches of skin.
  • Corneal arcus: Corneal arcus is the buildup of fat around the outside of the cornea. While corneal arcus is generally a typical part of aging, it can also be a symptom of hyperlipidemia.

Other people with hyperlipidemia may also notice high blood pressure as an initial symptom of the condition. However, high blood pressure is relatively nonspecific and can be a symptom of many other conditions.

Outside of these symptoms, hyperlipidemia doesn’t usually cause any outward symptoms for most people. Most people don’t know they have it until after routine bloodwork.

Hyperlipidemia is an incredibly common condition, affecting millions of people worldwide. Risk factors for the condition include:

Familial hyperlipidemia

There are several genetic forms of hyperlipidemia. The most common is FCHL, affecting roughly 1% of people.

FCHL features high cholesterol levels (hypercholesterolemia) or triglycerides (hypertriglyceridemia), as well as other lipid changes in the blood. FCHL is caused by a decrease in the number of LDL receptors and an increase in apolipoprotein B, a protein involved in lipid metabolism.

People born to certain racial or ethnic groups are more likely to carry gene mutations that lead to familial hyperlipidemia, especially familial hypercholesterolemia. These groups include:

  • Dutch Afrikaners
  • Ashkenazi Jews
  • South African Indians
  • French Canadians
  • Lebanese

Here are some frequently asked questions about hyperlipidemia. You may wish to discuss these further with a doctor.

When should I be screened for hyperlipidemia?

The Centers for Disease Control and Prevention (CDC) recommends that adolescents (ages 9 to 11) and young adults (ages 17 to 21) undergo lipid testing at least once during these age ranges. After this, the American Heart Association recommends cholesterol testing once every 4 to 6 years.

However, a doctor may recommend more frequent screening if you’re at high risk for hyperlipidemia based on family history or lifestyle choices.

What does it mean if I have high cholesterol or triglyceride levels?

Most lipoproteins are atherogenic, meaning that they can cause plaque to form in your arteries. For this reason, high lipid levels are strongly linked with heart disease.

In some cases, high triglyceride levels can also lead to acute pancreatitis, which is inflammation of the pancreas.

What treatment options are available for hyperlipidemia?

Doctors generally treat hyperlipidemia with a combination of lifestyle changes and, if necessary, medications. Lifestyle changes include dietary changes, regular physical activity, and weight loss. Medication options include statins and other lipid-lowering options.

With treatment, many people with hyperlipidemia can improve their cholesterol and LDL levels and lower their overall cardiovascular disease risk.

Hyperlipidemia is one of the most common risk factors for cardiovascular disease, affecting millions of people in the United States alone. It consists of multiple conditions characterized by abnormally high lipid levels in the blood. While hyperlipidemia can develop due to other underlying health conditions, genetics can also be a cause.

If you’re at a higher risk of developing hyperlipidemia because of your family history, consider reaching out to your doctor to discuss lipid testing. With regular testing, preventive lifestyle changes, and taking prescribed medications regularly, you can lower your risk of developing complications from this condition.