Hyperlipidaemia
Hyperlipidaemia is raised atherogenic lipoprotein cholesterol or triglycerides; it is usually silent, so treatment is based on overall cardiovascular risk, established disease, familial lipid disorders and pancreatitis risk rather than on a cholesterol number in isolation.
Definition
Hyperlipidaemia is elevation of circulating lipids, particularly LDL or other atherogenic non-HDL cholesterol and sometimes triglycerides. It may be primary, including familial hypercholesterolaemia, or secondary to another condition, lifestyle factor or medicine. It is a modifiable risk factor for atherosclerotic cardiovascular disease and, when triglycerides are very high, acute pancreatitis.
First principles
Atherogenic lipoprotein exposure drives atherosclerosis
LDL and other apolipoprotein-B-containing particles can enter the arterial wall and accumulate over time, promoting plaque formation and thrombosis. Non-HDL cholesterol captures the cholesterol carried by atherogenic particles and is useful when triglycerides are raised. HDL should not be treated as a stand-alone protective target; the clinical priority is reducing atherogenic lipoprotein burden and overall cardiovascular risk.
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