Blog
Hypercholesterolemia
Covenant Metabolic Specialists Health Library
Covenant Metabolic Specialists
Physician Reviewed
Dec 3, 2025
Hypercholesterolemia refers to elevated levels of total or LDL cholesterol in the blood, arising from diet, lifestyle, and polygenic influences distinct from monogenic familial hypercholesterolemia. It accelerates atherosclerosis, increasing the risk of coronary artery disease and stroke. Management focuses on lifestyle and pharmacologic LDL reduction.
Symptoms
The condition is typically asymptomatic until cardiovascular events occur. In severe long‑standing cases, cholesterol deposits can appear as xanthelasma or corneal arcus, but most patients discover high cholesterol through routine lipid panels rather than overt symptoms.
Causes
Excess intake of saturated and trans fats, obesity, sedentary lifestyle, hypothyroidism, nephrotic syndrome, cholestatic liver disease, medications such as corticosteroids, and multiple genetic variants collectively raise LDL cholesterol.
Risk Factors
Age over 45 in men, 55 in women, family history of early heart disease, smoking, hypertension, diabetes, obesity, and poor diet increase likelihood of hypercholesterolemia and its vascular consequences.
Diagnosis
A fasting or non‑fasting lipid panel reveals elevated LDL (>160 mg/dL) or non‑HDL cholesterol. Secondary causes are ruled out with thyroid, liver, and kidney tests. Risk calculators like ASCVD assess need for statin therapy.
Treatments
Lifestyle: Mediterranean‑type diet, 150 minutes of weekly exercise, weight loss, and smoking cessation. Medications: statins (first‑line), ezetimibe, PCSK9 inhibitors for high‑risk cases, bempedoic acid, or fibrates for mixed dyslipidemia. Omega‑3 ethyl esters target hypertriglyceridemia adjunctively.
Prevention
Heart‑healthy diet from childhood, regular physical activity, maintaining healthy body weight, avoiding tobacco, and periodic lipid screening starting at age 20. Early statin initiation in high‑risk patients prevents first myocardial infarctions.
Our Take
Routine cholesterol checks save lives. Covenant pairs labs with immediate counseling—because waiting months to discuss a 220 LDL wastes precious artery time.
Lowering LDL cholesterol is one of medicine’s clearest wins: every 40 mg/dL drop cuts major cardiovascular events by about 20 %. Covenant leverages evidence‑based drugs and lifestyle coaching to deliver those odds to every patient.
