Elevation of total cholesterol (TC) and/or LDL-cholesterol or non-HDL-cholesterol (defined as the subtraction of HDL-cholesterol from total cholesterol) in the blood, is also often referred to as dyslipidemia, to encompass the fact that it might be accompanied by a decrease in HDL-cholesterol or an increase in triglycerides.
Usually symptomatically quiescent until significant degrees of atherosclerosis have occurred.
Complications include MI, ischemic cardiomyopathy, sudden death, ischemic stroke, erectile dysfunction, peripheral vascular disease, and acute limb ischemia.
Risk factors for secondary hypercholesterolemia in industrialized populations include a sedentary lifestyle and a diet characterized by the excessive consumption of saturated fats, trans-fatty acids, and cholesterol. Other associations include diabetes, excess body weight mainly in the 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. Non-HDL cholesterol is calculated by the subtraction of HDL cholesterol from total cholesterol.
Treated with lifestyle modifications such as dietary changes, exercise, and smoking cessation, as well as pharmacologic intervention with statin therapy, supported by the use of niacin, bile acid sequestrants, or cholesterol absorption inhibitors (ezetimibe).
Hypercholesterolemia, an elevation of total cholesterol (TC) and/or LDL-cholesterol or non-HDL-cholesterol (defined as the subtraction of HDL-cholesterol from total cholesterol) in the blood, is also often referred to as dyslipidemia, to encompass the fact that it might be accompanied by a decrease in HDL-cholesterol or an increase in triglycerides. Dyslipidemia is classified as serum TC, LDL-cholesterol, triglyceride, apolipoprotein B (apoB), or lipoprotein (a) concentrations above the 90th percentile, or HDL-cholesterol or apolipoprotein A-I concentrations below the 10th percentile for the general population.
Associate Professor of Medicine
Director Lipid Clinic Heart Institute (InCor)
University of Sao Paulo Medical School Hospital
RDS has received honoraria for consulting, speaker activities and research from Astra Zeneca, Amgen, Boehringer-Ingelheim, Cerenis, Eli Lilly, Genzyme, Kowa, Pfizer, and Sanofi/Regeneron.
Assistant Professor of Medicine/Cardiology
Ciccarone Center for the Prevention of Heart Disease
Johns Hopkins University School of Medicine
SSM has received honoraria from the American College of Cardiology for educational activities. SSM is listed as a co-inventor on a pending patent filed by Johns Hopkins University for a novel method of LDL-cholesterol estimation. SSM received a charitable gift for the VLDL big data project from the Trone Foundation. SSM has received research support from the PJ Schafer Cardiovascular Research Fund, American Heart Association, Aetna Foundation, Google, and Apple. SSM has acted as a consultant for Abbott Nutrition, Pressed Juicery, Quest Diagnostics, Sanofi/Regeneron, Amgen, and the Pew Institute.
Dr Raul D. Santos and Dr Seth S. Martin would like to gratefully acknowledge Dr Martin Engelhardt and Dr Michael Miller, the previous contributors to this monograph. ME declares that he has no competing interests. MM has received research grant support and honoraria for lectures from AstraZeneca, Merck-Schering Plough, and Pfizer. MM has received consulting fees from Pfizer, Merck-Schering Plough, and Roche.
Assistant Professor of Medicine
Case Western Reserve University
MLA declares that he has no competing interests.
Consultant/Senior Lecturer in Diabetes & Metabolism
The Royal Oldham Hospital & University of Manchester Cardiovascular Research Group Diabetes Centre
Royal Oldham Hospital
DB declares that he has no competing interests.
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