Fast Facts on Lipids

Lipids

• "Lipid" is a medical term used to describe fats in the bloodstream, more commonly referred to as cholesterol and triglycerides.
• Lipids are stored in the body to serve as a source of fuel and play an important role in the structure of cells
• Blood is made up primarily of water. Just like oil and water, blood and lipids do not mix because lipids are essentially water-insoluble molecules. In order to move through the bloodstream, lipids have to combine with proteins to form lipoproteins.

• A lipid profile is a group of blood tests conducted by a healthcare provider to calculate the levels of cholesterol and triglycerides in a patient's blood.
• A common lipid profile measures concentrations of low-density lipoprotein (LDL, also known as "bad" cholesterol), high-density lipoprotein (HDL, also known as "good" cholesterol), triglycerides (TG) and total cholesterol (the sum of LDL and HDL in the blood).
• Physicians look at the results of a lipid profile, as well as other risk factors, to help determine a patient's risk for developing cardiovascular disease. This information is useful to determine if any treatment is necessary.

• Excess amounts of LDL cholesterol circulating in the blood can lead to an increased risk of heart disease, including heart attack or stroke. .
• Studies have shown that lowering patients' LDL level reduced their risk of cardiovascular disease.
• The chart below outlines the National Cholesterol Education Program's classifications of LDL levels.

LDL Cholesterol Levels	Classification
Less than 100 mg/dL	Optimal
100 to 129 mg/dL	Near optimal/Above optimal
130 to 159 mg/dL	Borderline high
160 to 189 mg/dL	High
190 mg/dL and above	Very high

• HDL cholesterol helps clear excess LDL cholesterol from the arteries and transports it to the liver to be removed from the body.
• Low levels of HDL have been linked to an increased risk for cardiovascular disease, while high levels of HDL seemed to protect against heart disease.
• The chart below outlines the National Cholesterol Education Program's classifications of HDL levels.

HDL Cholesterol Levels	Classification
Less than 40 mg/dL	Low
60 mg/dL and above	High

• Triglycerides are a type of fat found in the blood.
• Triglycerides are both produced by the body and ingested through the food you eat.
• High levels of triglycerides are common in people who are obese, have diabetes or have low HDL levels.
• Elevated triglycerides are increasingly viewed as an independent risk factor for cardiovascular disease.
• The chart below outlines the National Cholesterol Education Program's classifications for triglyceride levels.

• The first treatment option for any patient with dyslipidemia (abnormal lipid levels) should be lifestyle changes. This includes reducing consumption of foods that are high in calories and sugars, increasing physical activity, maintaining a healthy weight, reducing alcohol consumption and quitting smoking.
• For some patients, these lifestyle changes alone may be enough to improve lipid levels.
• When lifestyle changes aren't enough, the guidelines of the National Lipid Association and the National Cholesterol Education Program, outlined below, suggest prescription options to help improve lipid levels. For patients who are unable to achieve target lipid levels with one medication ("monotherapy"), a combination of medications may be needed.
• Elevated LDL: Statins are commonly considered the most effective medication to specifically help reduce LDL level. Bile acid sequestrants, nicotinic acid and fibrates have all been shown to help decrease LDL levels to a lesser extent.
• Low HDL: Nicotinic acid has been shown to be an effective medication to help increase HDL levels.16 Fibrates are also prescribed to help increase increase HDL. Statins have been shown to help increase HDL levels to a lesser extent.
• Elevated Triglycerides: Fibrates are an effective treatment option to help lower triglycerides. Nicotinic acid is also used to help decrease triglycerides. Statins have been shown to help decrease triglycerides to a lesser extent.

Created: 1/30/2007  -  Donnica Moore, M.D.