Raised blood lipids
Raised blood lipids, most often raised cholesterol and triglycerides, are one of the key risk factors for the development of atherosclerosis, coronary heart disease, heart attack and stroke. It is a condition that usually causes no symptoms, so it is only detected by a routine blood test. That is exactly why it is called a ‘silent’ risk factor – damage to the blood vessels can develop for years without the patient noticing any symptoms.
The most important value in a lipid profile is LDL cholesterol, often called ‘bad’ cholesterol. It is LDL that plays the greatest part in forming the atherosclerotic plaques that narrow the blood vessels and increase the risk of cardiovascular events. HDL cholesterol, by contrast, has a protective role because it helps to remove excess cholesterol from the blood vessels. Triglycerides are a type of fat associated with excess body weight, a poor diet, insulin resistance and excessive alcohol intake.
Raised blood lipids can be influenced by genetics, a diet high in saturated fat, obesity, lack of physical activity, diabetes, hormonal disorders and some chronic diseases. Many people also have an inherited tendency to very high LDL cholesterol levels, known as familial hypercholesterolaemia – a condition that carries a particularly high risk and requires earlier and more aggressive treatment.
Treatment of raised blood lipids combines lifestyle changes with medication where needed. The foundations are a healthy diet lower in saturated fat, eating more vegetables, fruit, fibre and fish, regular physical activity, losing weight and stopping smoking. When lifestyle changes are not enough or the risk is high, medicines such as statins are prescribed; they are the most effective at lowering LDL cholesterol and have been proven to reduce the risk of heart attack and stroke. If needed, other medicines such as ezetimibe or PCSK9 inhibitors can be added.
Target cholesterol levels depend on each person's cardiovascular risk – people who have already had a heart attack, a stent or heart surgery, or who have diabetes, are in a high-risk group, and lower LDL targets are recommended for them. Regular lipid profile checks and risk assessment are key to timely treatment and preventing complications.
Although raised blood lipids are painless and usually cause no symptoms, recognising and treating them in good time is one of the most effective ways to protect the heart and blood vessels in the long term.
