The silent threat of hyperlipidaemia lurking in everyday joys

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

This stealthy menace, known as hyperlipidaemia or high cholesterol, remains silent until it triggers serious health issues down the line.

What is hyperlipidaemia, and why should it concern you?

“Hyperlipidaemia is a condition that often goes unnoticed because it usually doesn’t present symptoms until it leads to severe health events,” explains Marilize Hattingh, a pharmacist at Medipost Pharmacy. “It’s a silent threat that many people only become aware of after experiencing a stroke or heart attack.”

“Simply put, hyperlipidaemia means having high levels of fats, such as cholesterol and triglycerides, in your blood. When these fats accumulate, they form plaque in your blood vessels. This plaque buildup, known as atherosclerosis, narrows the arteries and raises the risk of high blood pressure, heart attacks, strokes, and peripheral artery disease,” she adds.

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

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

The chronic nature of hyperlipidaemia

“Hyperlipidaemia is a chronic condition that generally requires lifelong management. In South Africa, it’s classified as one of the 26 prescribed minimum benefit (PMB) conditions on the chronic disease list,” says Hattingh.

“Lifestyle factors like being overweight, smoking, and excessive alcohol consumption can contribute to high cholesterol levels, but genetics also play a significant role. Understanding whether hyperlipidaemia is lifestyle-induced or genetic is crucial for effective management,” she notes.

The role of medications

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

“Statins are essential in treating hyperlipidaemia as they effectively reduce bad cholesterol and lower the risk of heart disease,” Hattingh says. “Newer treatments like 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 costly and are usually not the first-line option.”

Monitoring and side effects

Regular blood tests are crucial for tracking treatment effectiveness. Your doctor will typically request a lipogram every six months to measure LDL, HDL, VLDL, and triglyceride levels. This monitoring helps adjust treatment plans for optimal results.

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