Hyperlipidaemia means a high level of cholesterol or triglycerides in your blood.
What causes hyperlipidaemia?
Hyperlipidaemia is often found when people are overweight or have an unhealthy diet. It can also be the result of drinking too much alcohol. It can be something that you may have inherited through your family genes (known as primary hyperlipidaemia) and approximately 1 person in 500 will have this cause.
It may be because of another medical condition that you may have, such as diabetes, when it is known as secondary. Other causes include:
- An underactive thyroid gland (hypothyroidism).
- Obstructive jaundice.
- Cushing's syndrome.
- Anorexia nervosa.
- Nephrotic syndrome.
- Chronic kidney disease.
Some prescribed medicines can affect your cholesterol level, including:
- Thiazide diuretics (used to control blood pressure).
- Glucocorticoids (steroids).
- Ciclosporin (used after organ transplants).
- Antiretroviral therapy (used to treat HIV infection).
- Beta-blockers (used to control heart rate).
- The combined oral contraceptive pill.
- Atypical antipsychotics (used in some mental health problems).
- Retinoic acid derivatives (used in some skin conditions).
How do I know if I have hyperlipidaemia?
- Hyperlipidaemia is often found during routine screening when your doctor is trying to assess your risk of having heart attacks or strokes. This may be as part of an annual health check if you are over 40 years of age, or if you have a close relative who had these problems at a young age.
- Usually, the diagnosis is made after a fasting blood test. Fasting means at least 12 hours when you have not eaten. You are allowed to drink water.
- There are also changes that may be visible on your body if you have the inherited form of hyperlipidaemia:
- Premature arcus senilis - this is a white or grey ring that is visible when your doctor looks at the front of your eyes.
- Tendon xanthomata - these are hard nodules that you may find in the tendons of the knuckles and the Achilles (at the back of your ankle).
- Xanthelasma - fatty deposits in the eyelids.
What can I do to lower my lipid levels?
Hyperlipidaemia can be treated both by eating a healthy diet and by taking a medicine to reduce your cholesterol level. It is also very important to lower any other risk factors for cardiovascular diseases, such as doing regular physical activity and not smoking. See the separate leaflet called Cardiovascular Disease (Atheroma) for more information.
Changing from an unhealthy diet to a healthy diet can reduce a cholesterol level. However, dietary changes alone rarely lower a cholesterol level enough to change a person's risk of cardiovascular disease from a high-risk category to a lower-risk category. A healthy diet has other benefits too, apart from reducing the level of cholesterol. See also the separate leaflet called Healthy Eating.
If you are at high risk of developing a cardiovascular disease then medication is usually advised along with advice to tackle any lifestyle issues, including diet. Medication can be used to lower your cholesterol or triglyceride level, usually with a statin medicine. Read more about statins and other lipid-lowering medicines for further details.
Further reading and references
Lipid modification - cardiovascular risk assessment and the modification of blood lipids for the prevention of primary and secondary cardiovascular disease; NICE Clinical Guideline (July 2014 - updated May 2023)
Familial hypercholesterolaemia: identification and management; NICE Clinical Guideline (2008, last updated October 2019)
Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk; European Society of Cardiology/European Atherosclerosis Society (2019)
2021 European Guidelines on cardiovascular disease prevention in clinical practice; European Society of Cardiology (2021)
Hypercholesterolaemia - familial; NICE CKS, December 2022 (UK access only)
Lipid modification - CVD prevention; NICE CKS, August 2022 (UK access only).
Linton MF, Yancey PG, Davies SS, et al; The Role of Lipids and Lipoproteins in Atherosclerosis. Endotext 2019.