Summary

• Elevation of total cholesterol or elevation of cholesterol in circulating lipoproteins, including chylomicrons, LDL, VLDL, and intermediate-density lipoprotein. May be accompanied by a decrease in HDL.
• Usually symptomatically quiescent until significant degrees of atherosclerosis have occurred.
• Complications include MI, ischaemic cardiomyopathy, sudden death, stroke, erectile dysfunction, peripheral vascular disease, and acute limb ischaemia.
• Risk factors for secondary hypercholesterolaemia in industrialised populations include a sedentary lifestyle and a diet characterised by the excessive consumption of saturated fats, trans-fatty acids, and cholesterol. Other causes include diabetes, excess body weight mainly in abdominal region, hypothyroidism, nephrotic syndrome, and cholestatic liver disease. Low HDL-cholesterol levels are associated with smoking and abdominal obesity.
• Diagnosed by fasting lipid profile, consisting of measurements of total cholesterol, LDL (estimated or direct), HDL, and triglycerides.
• Treated with lifestyle modifications such as dietary changes and exercise, as well as pharmacological intervention with statin therapy, nicotinic acid, bile acid sequestrants, or cholesterol absorption inhibitors (ezetimibe).