Hyperlipoproteinemia, also known as hyperlipidemia, is a group of disorders characterized by abnormally elevated levels of lipids/lipoproteins in blood. Due to their water-insoluble properties, lipids combine with lipoproteins in order to be transported through the bloodstream. Elevated lipid and lipoprotein levels can predispose people to atherosclerosis, leading to increased risk of developing cardiovascular disease.
There are five types of hyperlipoproteinemia, each classified based on the density and type of lipoproteins involved.
1. Pure hypercholesterolemia (Type 1) – characterized by high LDL (low-density lipoprotein) cholesterol and normal triglycerides
2. Familial hyperchylomicronemia (Type 2) – characterized by normal cholesterol and high triglycerides
3. Dysbetalipoproteinemia (Type 3) – characterized by high cholesterol and high triglycerides
4. Familial hypertriglyceridemia (Type 4) – characterized by high VLDL (very low-density lipoprotein) cholesterol and normal triglycerides
5. Mixed hyperlipoproteinemia (Type 5) – characterized by high VLDL cholesterol and high chylomicrons Hyperlipoproteinemia can result from primary or secondary causes.
The primary causes are specific genetic abnormalities, involving defective apoE binding or apoE deficiency, which affects the normal lipid metabolism. The secondary causes are typically the result of another underlying medical condition that leads to lipid and lipoprotein abnormalities.
Learning how to relax and cope in stressful environments can reduce this risk. Useful and simple ways to reduce stress include physical activity, yoga, meditation and other relaxation therapy. Counseling or medications may be required to treat signs of depression. Even if a heart attack or stroke has already occurred, it is never too late to adopt a healthy lifestyle, as it will significantly decrease the risk of future cardiovascular problems.
Medications
For many people who are at risk of cardiovascular disease, maintaining a healthy lifestyle is all that is required to reduce and stabilize LDL-cholesterol and triglyceride levels. However, for those that are already suffering from serious symptoms (e.g. a recent heart attack), medications are started immediately to prevent further complications.
Medications used to reduce LDL-cholesterol include statins, resins, fibrates, cholesterol absorption inhibitors, and niacin. These medications reduce the risk of any further clogging and plaque formation in the arteries by removing excess “bad” LDL-cholesterol or increasing the “good” HDL-cholesterol.
Procedures and Surgery
Medical procedures and surgery may be required to treat severe cases of cardiovascular disease and are more common in the elderly. Often this occurs in people that were not aware of their elevated cholesterol or triglyceride levels, until a serious complication (e.g. heart attack or stroke) occurred.
Angioplasty is a procedure to open arteries that have become narrowed or blocked from plaque formation. This involved the insertion of a thin, flexible tube with an attached balloon into a blood vessel. The balloon is inflated in the narrow or blocked region of the artery to restore blood flow.
A heart bypass may be required for severely blocked arteries. This involves the grafting of blood vessels so that blood flow can go around (bypass) the blocked coronary artery and therefore provide an adequate blood supply to the affected tissues.
Cardiac rehabilitation is also recommended for anyone that has suffered a heart attack or undergone a medical procedure or surgery. This rehabilitation involves safe exercise training and education and counseling to reduce the risk of future heart problems.
Treating Hyperlipoproteinemia Type III
Hyperlipoproteinemia type III risk can be reduced by maintaining the heart-healthy lifestyle described above. In this situation, it is also very important to minimize carbohydrate and sugar intake. Medications, such as statins, are another effective treatment for this disorder. Surgery may be required to remove xanthomas. Hyperlipoproteinemia type III can increase the risk of diabetes, hence it is very important to monitor and maintain stable blood sugar levels to avoid further diabetic complications.
