This article was first published on February 4, 2024. It was last reviewed, updated, or edited on February 4, 2024.
What is “dyslipidemia”?
“Dyslipidemia” is an umbrella term that includes all abnormalities of lipid metabolism (Arvanitis and Lowenstein, 2023).
So, the term “dyslipidemia” should usually be preferred over the term “hyperlipidemia”.
Dyslipidemia includes, among other conditions:
– Increase in serum total cholesterol
– Increase in serum low-density lipoprotein cholesterol (LDL-C)
– Decrease in serum high-density lipoprotein cholesterol (HDL-C)
– Increase in serum triglycerides (hypertriglyceridemia)
Why dyslipidemia is a VERY serious problem
In all of these forms, dyslipidemia, especially elevated LDL-C, is one of the most important risk factors for atherosclerotic cardiovascular disease (ASCVD), a term we should be very familiar with.
When atherosclerosis “clogs up the arteries”, this affects all parts of the body. Most importantly, ASCVD includes (source):
– Coronary heart disease (myocardial infarction, angina, coronary artery stenosis
– Cerebrovascular disease (transient ischemic attack, ischemic stroke, carotid artery stenosis)
– Peripheral artery disease
– Aortic atherosclerotic disease.
ASCVD is one of the MAIN causes of disease and death (Rout et al., 2023; Arvanitis and Lowenstein, 2023).
And, dyslipidemia is among the leading causes of ASCVD (Arvanitis and Lowenstein, 2023).
Unaware and untreated
Shockingly, given how serious the consequences of elevated LDL cholesterol can be, in the United States, about 1 in 4 persons with an LDL-C level of > 190 mg/dL are “unaware and untreated” (Sayed et al., 2023).
My guess is that persons with mental disorders may be a disproportionately high percentage of those with undiagnosed and untreated dyslipidemia. I think that we should resolve to make sure that dyslipidemia does not go undiagnosed in any of our patients and, hopefully, not untreated either.
Dyslipidemia is also important for mental health clinicians because some psychiatric medications—especially second-generation antipsychotics—can be associated with dyslipidemia.
For more on this, please see the following article on this website:
We must identify and treat dyslipidemia associated with antipsychotic medications
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References
Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, Khera A, Lloyd-Jones D, McEvoy JW, Michos ED, Miedema MD, Muñoz D, Smith SC Jr, Virani SS, Williams KA Sr, Yeboah J, Ziaeian B. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Sep 10;140(11):e563-e595. doi: 10.1161/CIR.0000000000000677. Epub 2019 Mar 17. Erratum in: Circulation. 2019 Sep 10;140(11):e647-e648. Erratum in: Circulation. 2020 Jan 28;141(4):e59. Erratum in: Circulation. 2020 Apr 21;141(16):e773. PMID: 30879339; PMCID: PMC8351755.
Arvanitis M, Lowenstein CJ. Dyslipidemia. Ann Intern Med. 2023 Jun;176(6):ITC81-ITC96. doi: 10.7326/AITC202306200. Epub 2023 Jun 13. PMID: 37307585.
Rout A, Duhan S, Umer M, Li M, Kalra D. Atherosclerotic cardiovascular disease risk prediction: current state-of-the-art. Heart. 2023 Nov 2:heartjnl-2023-322928. doi: 10.1136/heartjnl-2023-322928. Epub ahead of print. PMID: 37918900.
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