The silent threat that lurks in the joys of everyday life

Imagine enjoying a sunny afternoon stroll in the park or a warm family dinner, unaware of a hidden threat quietly building inside your body.

This stealthy threat, known as hyperlipidemia or high cholesterol, remains silent until it triggers serious health problems.

What is hyperlipidemia and why should you be concerned?

“Hyperlipidemia is a condition that often goes unnoticed because it usually doesn’t show symptoms until it leads to serious health problems,” says Marilize Hattingh, a pharmacist at Medipost Pharmacy. “It’s a silent threat that many people only become aware of after they have suffered a stroke or heart attack.”

“In simple terms, hyperlipidemia means having high levels of fats, like cholesterol and triglycerides, in your blood. When these fats build up, they form plaques in your blood vessels. This plaque buildup, known as atherosclerosis, narrows your arteries and increases your risk of high blood pressure, heart attack, stroke, and peripheral artery disease,” she adds.

“It’s important to note that not all cholesterol is harmful,” Hattingh says.

“Low-density lipoprotein (LDL) is often called “bad” cholesterol because it can clog arteries, while high-density lipoprotein (HDL) is “good” cholesterol because it helps break down LDL. Very-low-density lipoprotein (VLDL) and triglycerides are other fats that need to be balanced for good health,” she explains.

The chronic nature of hyperlipidemia

“Hyperlipidaemia is a chronic condition that usually requires lifelong management. In South Africa, it is classified as one of 26 diseases requiring minimum benefits (PMB) on the list of chronic diseases,” says Hattingh.

“Lifestyle factors such as being overweight, smoking and excessive alcohol consumption can contribute to high cholesterol, but genetics also play an important role. Understanding whether hyperlipidemia is lifestyle- or genetic-induced is essential for effective management,” she notes.

The role of drugs

Management of hyperlipidemia often involves a combination of lifestyle changes and medications. Statins are the most commonly prescribed medications to lower cholesterol by reducing the liver’s production of cholesterol, thereby lowering levels of “bad” LDL and VLDL cholesterol.

“Statins are essential in the treatment of hyperlipidemia because they effectively lower bad cholesterol and reduce the risk of heart disease,” Hattingh says. “Newer treatments such as ezetimibe, which prevents cholesterol absorption in the intestine, and PCSK9 inhibitors such as alirocumab and evolocumab, which significantly lower LDL levels, are also available. However, these newer treatments can be expensive and are generally not the first-line option.”

Monitoring and side effects

Regular blood tests are essential to monitor the effectiveness of treatment. Your doctor will typically order a lipogram every six months to measure LDL, HDL, VLDL, and triglyceride levels. This monitoring allows treatment plans to be adjusted for optimal results.

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