Dyslipidemia: The Silent Killer

Why “High Cholesterol” Is More Serious Than It Sounds

Many people casually say they have “high cholesterol,” usually followed by advice to cut down on oily foods. What often gets missed is that this simple phrase describes a medical condition called dyslipidemia, one of the leading risk factors for heart disease and stroke worldwide.

Dyslipidemia rarely causes pain or obvious warning signs. That silence is exactly why it is dangerous. Problems can build quietly in the blood vessels for years before showing up as a heart attack or stroke.

What Exactly Is Dyslipidemia?

Dyslipidemia means having abnormal levels of fats (lipids) in the blood. These fats include cholesterol and triglycerides. Your body needs them in small amounts to function properly, but trouble starts when the balance is off.

The most common problems are:

• Too much LDL cholesterol, often called bad cholesterol

• Too little HDL cholesterol, known as good cholesterol

• High levels of triglycerides, a type of fat linked to heart disease

When these levels stay abnormal for a long time, fatty deposits can build up inside blood vessels. This process is called atherosclerosis, and it reduces blood flow to vital organs.

The Two Main Types: Inherited or Acquired

1. Primary (Inherited) Dyslipidemia

This form runs in families. Genetic changes affect how the body makes or removes cholesterol from the blood. A well-known example is ‘familial hypercholesterolemia’, where LDL cholesterol is very high from childhood.

2. Secondary (Acquired) Dyslipidemia

This is far more common and develops due to other conditions or lifestyle factors, such as:

• Diabetes

• Obesity

• Underactive thyroid (hypothyroidism)

• Kidney or liver disease

• Excessive alcohol intake

• Certain medicines, including steroids and some blood pressure or HIV drugs

Often, more than one factor is involved.

How Does Dyslipidemia Develop?

Dyslipidemia occurs when the body produces more fats than it can clear, or clears them too slowly. Contributing factors include:

• Diets high in saturated and trans fats

• Little physical activity

• Smoking

• Excess body weight

• Hormonal or metabolic disorders

• Long-term use of certain medications

It is usually the result of habits and health conditions working together over time.

Why Should You Be Concerned?

High LDL cholesterol can move into the walls of blood vessels and trigger inflammation. Over time, this leads to plaque formation that narrows the arteries.

If a plaque breaks open, a blood clot can form and suddenly block blood flow. This can cause:

a. A heart attack

b. A stroke

c. Peripheral arterial disease, which affects blood flow to the legs

Low HDL cholesterol makes things worse because HDL helps carry excess cholesterol away from the blood vessels.

How Is Dyslipidemia Diagnosed?

Dyslipidemia is diagnosed using a blood test called a lipid profile. This test measures: Total cholesterol, LDL cholesterol, HDL cholesterol, and Triglycerides.

Some tests are done without fasting, while others may require fasting, depending on the situation. Doctors usually interpret the results alongside other risk factors such as age, blood pressure, diabetes, and smoking status to estimate overall heart disease risk.

Are There Any Symptoms?

Most people with dyslipidemia feel completely normal. That is why regular screening is so important.

In severe or inherited cases, physical signs may appear, including:

• Yellowish deposits on the skin or eyelids (called xanthomas or xanthelasma)

• A gray or white ring around the colored part of the eye, especially in younger people

More often, dyslipidemia is discovered only after a serious heart or blood vessel problem has already occurred.

How Is Dyslipidemia Treated?

Treatment depends on cholesterol levels and overall heart disease risk.

A. Healthy habits are essential for everyone with dyslipidemia:

i. Eating a heart-healthy diet

ii. Being physically active

iii. Reaching and maintaining a healthy weight

iv. Limiting alcohol intake

v. Quitting smoking

B. When lifestyle changes are not enough, Doctors may prescribe medicines such as:

i. Statins to lower LDL cholesterol

ii. Fibrates for high triglycerides

iii. Cholesterol absorption blockers

iv. PCSK9 inhibitors for people at very high risk

Treatment plans are tailored to each person and reviewed regularly.

Common Myths, Cleared Up

1. “Only older people have cholesterol problems.”

Dyslipidemia can affect young adults and even children, especially when it is inherited.

2. “I feel fine, so my cholesterol must be normal.”

Most people have no symptoms until serious damage has occurred.

3. “Medication alone will fix it.”

Medicines work best when combined with healthy lifestyle choices.

4. “All fats are bad.”

Some fats, such as unsaturated fats, are actually good for heart health.

Protecting Your Heart Starts Early

Dyslipidemia may be silent, but its consequences are not. Regular cholesterol checks, healthy living, and proper treatment can greatly reduce the risk of heart attack and stroke.

If you have not had your cholesterol checked recently, speaking with a healthcare professional could be one of the most important steps you take for your heart health.

References

American Heart Association. (2023). Cholesterol. https://www.heart.org/en/health-topics/cholesterol

Centers for Disease Control and Prevention. LDL and HDL Cholesterol and Triglycerides. Updated May 15, 2024. Accessed January 2026. https://www.cdc.gov/cholesterol/about/ldl-and-hdl-cholesterol-and-triglycerides.html

Cleveland Clinic. Hyperlipidemia (High Cholesterol). Updated 2026. Accessed January 2026. https://my.clevelandclinic.org/health/diseases/21656-hyperlipidemia

Grundy, S. M., Stone, N. J., Bailey, A. L., et al. (2019). 2018 guideline on the management of blood cholesterol. Circulation, 139(25), e1082–e1143. https://doi.org/10.1161/CIR.0000000000000625

Assessed and Endorsed by the MedReport Medical Review Board