Primary hyperlipidemia is a condition characterized by persistently elevated blood lipid levels due to genetic or metabolic abnormalities. Treatment includes medication, lifestyle modifications, and regular monitoring. Genetic factors, metabolic abnormalities, and environmental factors are the main causes.
1. Genetic factors are an important cause of primary hyperlipidemia. Familial hypercholesterolemia is a common hereditary hyperlipidemia caused by gene mutations leading to abnormal low-density lipoprotein receptor function, resulting in significantly elevated blood cholesterol levels. Familial mixed hyperlipidemia is characterized by simultaneous elevations in both cholesterol and triglyceride levels, exhibiting a clear familial aggregation. Familial hypertriglyceridemia is mainly caused by gene mutations leading to abnormal triglyceride metabolism, resulting in significantly elevated blood triglyceride levels.
2. Metabolic abnormalities are another important cause of primary hyperlipidemia. The liver is the main organ for lipid metabolism, and abnormal liver function can lead to lipid metabolism disorders. Insulin resistance is a core feature of metabolic syndrome and can cause lipid metabolism abnormalities. Hypothyroidism can affect lipid metabolism, leading to elevated cholesterol and triglyceride levels.
3. Environmental factors play an important role in the development and progression of primary hyperlipidemia. A high-fat, high-sugar diet can lead to excessive energy intake, promoting lipid synthesis and accumulation. Lack of exercise can lead to reduced energy expenditure, promoting lipid accumulation. Smoking and alcohol consumption can affect lipid metabolism, leading to elevated lipid levels.
4. Drug therapy is the main treatment for primary hyperlipidemia. Statins are the first-line drugs for lowering cholesterol, reducing blood cholesterol levels by inhibiting cholesterol synthesis. Fibrates are mainly used to lower triglycerides, promoting triglyceride breakdown by activating lipoprotein lipase. PCSK9 inhibitors are a new type of lipid-lowering drug that significantly reduces cholesterol levels by increasing the number of low-density lipoprotein receptors through inhibiting PCSK9 activity.
5. Lifestyle modifications are an important adjunct to the treatment of primary hyperlipidemia. Dietary control is fundamental; a low-fat, low-sugar, high-fiber diet is recommended, along with increased intake of fruits and vegetables. Regular exercise helps improve lipid metabolism; at least 150 minutes of moderate-intensity aerobic exercise per week is recommended. Quitting smoking and limiting alcohol consumption help improve lipid metabolism and reduce the risk of cardiovascular disease.
6. Regular monitoring is a crucial part of managing primary hyperlipidemia. Monitoring blood lipid levels helps assess treatment effectiveness and adjust treatment plans. Liver function monitoring helps detect drug-related adverse reactions promptly. Cardiovascular risk assessment helps develop individualized treatment plans.
Primary hyperlipidemia is a chronic disease requiring long-term management. Through comprehensive treatment and lifestyle modifications, blood lipid levels can be effectively controlled, reducing the risk of cardiovascular disease. Patients should actively cooperate with treatment, undergo regular monitoring, and maintain healthy lifestyle habits to achieve long-term effective blood lipid management.