Diagnosis and Causes of Hypercholesterolemia

High cholesterol is diagnosed by a total lipid molecule greater than 200 mg/dL. People with this condition should have a fasting low density lipoprotein (LDL or bad cholesterol) and high density lipoprotein (HDL or good cholesterol) performed to better determine their health risk. Increased levels of this organic molecule in the blood is caused by heredity, obesity, physical inactivity, and an unhealthy diet. Screening or lipid panel is recommended for adults 20 years old or older, especially if there is an increased risk of coronary artery disease.

Risk factors for coronary artery disease include:

  • Men over 45 years of age, women over 55 years of age

  • Family history of coronary artery disease in a first degree relative (parent or sibling) at a young age

  • High blood pressure

  • Tobacco abuse

  • Diabetes

  • Obesity

  • Stress

  • Sedentary lifestyle

Cholesterol lowering drugs include the statins, niacin, bile acid binding resins, fibrates, and ezetimibe.

Cholesterol Lowering Treatments  

These treatments lead to reduction in deaths and recurrent heart and vascular events (heart attack, stroke, and peripheral vascular disease) for patients with known heart disease. Decisions to start lipid lowering medications are based on LDL levels and the person’s risk factor profile:

  • Low risk – treat when LDL greater than 189 (LDL goal is less than 160)

  • Moderate risk – treat when LDL greater than 159 (LDL goal is less than 130)

  • Moderately high risk – treat when LDL greater than 129 (LDL goal is less than 100)

  • High risk – treat when LDL greater than 100 (LDL goal is less than 70)

Cholesterol lowering drugs include the statins, niacin, bile acid binding resins, fibrates, and ezetimibe. It is important that you follow up with your health care provider regularly to monitor your condition and adjust medications as appropriate. Chronic health problems such as type 2 diabetes, high blood pressure or hypertension are significant contributors to worse events such as heart attack, stroke, and congestive heart failure if not appropriately managed.