Dyslipidaemia

Dyslipidaemia is an abnormal level of cholesterol or triglycerides in the blood. It produces no symptoms, but it silently narrows the arteries supplying the heart and brain, and it is one of the few heart-attack risks that can be measured with a single blood test.

Symptoms

Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.

• No symptoms in the great majority of people
• Fatty deposits around the eyelids or over tendons in severe inherited forms
• A white ring around the cornea in younger patients
• Symptoms appear only once the arteries are affected — chest pain on exertion, stroke, or leg pain on walking
• Abdominal pain in very high triglyceride levels, from pancreatitis

When to see a doctor

• Any adult over 30, or earlier with a family history of early heart attack
• Anyone with diabetes, high blood pressure, obesity or a smoking history
• Chest discomfort on exertion, or calf pain that appears on walking and settles on rest
• Severe upper abdominal pain in someone with known very high triglycerides

Tests that may be advised

Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.

• Fasting lipid profile — total cholesterol, LDL, HDL and triglycerides
• Blood sugar and HbA1c
• Thyroid function and liver function tests
• Kidney function and urine protein
• ECG, and cardiac assessment where risk is high

How it is treated

Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.

• Reducing fried food, coconut oil reuse, bakery items and visible fat in the diet
• Increasing fibre, pulses, vegetables and fish; controlling alcohol for high triglycerides
• Regular aerobic activity and weight reduction
• Lipid-lowering medication where risk assessment or levels justify it, taken long term
• Repeat lipid profile after treatment starts, then periodic monitoring