Dyslipidemia is often asymptomatic until complications arise. Key indicators include:

• No Immediate Symptoms: Detected via routine blood tests (lipid profile).
• Advanced Complications:
  • Xanthomas: Fatty deposits under the skin (elbows, knees).
  • Corneal Arcus: Gray-white ring around the cornea.
  • Atherosclerosis Symptoms: Chest pain (angina), leg cramps (claudication).

Note: Severe hypertriglyceridemia (>500 mg/dL) may cause acute pancreatitis (Lippincott Review of Pathology).

1. Primary (Genetic) Causes:
   • Familial Hypercholesterolemia: Mutations in LDLR or APOB genes.
   • Familial Hypertriglyceridemia: Overproduction of triglycerides.
2. Secondary Causes:
   • Lifestyle: Poor diet, sedentary habits, obesity, smoking.
   • Medical Conditions: Diabetes, hypothyroidism, chronic kidney disease.
   • Medications: Beta-blockers, corticosteroids, retinoids (BNF).

Key Insight: Over 60% of dyslipidemia cases are linked to modifiable lifestyle factors (WHO).

1. Dietary Modifications:
   • Reduce saturated fats (<7% of calories) and trans fats; increase fiber (25–30 g/day) (Mayo Clinic).
   • Adopt the Mediterranean diet: Rich in olive oil, nuts, and fish.
2. Physical Activity:
   • 150 minutes/week of moderate exercise (e.g., brisk walking).
3. Weight Management:
   • Aim for BMI 18.5–24.9; waist circumference <40" (men) or <35" (women).
4. Regular Screening:
   • Lipid profiles every 4–6 years for adults >20; more frequently for high-risk individuals (WHO).

1. Lifestyle Interventions:

• Diet: Emphasize plant sterols, omega-3 fatty acids (fish, flaxseeds).
• Exercise: Lowers triglycerides and raises HDL.

2. Pharmacotherapy (BNF Guidelines):

• Statins (e.g., Atorvastatin): First-line for lowering LDL; reduce CVD risk by 25–35%.
• Ezetimibe: Inhibits cholesterol absorption; used with statins for synergy.
• PCSK9 Inhibitors (e.g., Alirocumab): For familial hypercholesterolemia or statin intolerance.
• Fibrates (e.g., Fenofibrate): Lower triglycerides by 30–50%.
• Niacin: Raises HDL but limited by side effects (flushing).

3. Advanced Therapies:

• LDL Apheresis: For refractory familial hypercholesterolemia.
• Gene Therapy: Emerging treatments targeting PCSK9 (Lippincott Textbook of Pharmacology).

• Atherosclerosis: Leading to heart attack, stroke, or peripheral artery disease.
• Acute Pancreatitis: From severe hypertriglyceridemia (>1,000 mg/dL).
• Metabolic Syndrome: Cluster of conditions increasing CVD and diabetes risk (Lange Textbook of Clinical Pharmacology).

• Regular Monitoring: Annual lipid profiles and liver function tests (for statin users).
• Medication Adherence: Avoid abrupt discontinuation of statins.
• Patient Education: Recognize drug interactions (e.g., statins with grapefruit juice).

Dyslipidemia is a silent yet modifiable risk factor for life-threatening cardiovascular events. Through early detection, lifestyle changes, and tailored pharmacotherapy, patients can significantly reduce complications. Advances in therapies like PCSK9 inhibitors offer hope for challenging cases.
Key Takeaways:
• Prioritize regular lipid screening and heart-healthy habits.
• Follow prescribed treatments and attend follow-up appointments.
• Stay informed about new guidelines and therapies.