Which diseases and medications can cause secondary dyslipidemia?

What diseases and medications can cause elevated blood lipids?

Some systemic diseases can also cause elevated blood lipids, such as nephrotic syndrome, hypothyroidism, systemic lupus erythematosus, and liver disease. Certain medications, such as diuretics, beta-blockers, and glucocorticoids, may also cause elevated blood lipids. For elevated blood lipids caused by these diseases, treating the primary disease or discontinuing the corresponding medication will lower blood lipid levels. These conditions should be ruled out when diagnosing dyslipidemia.

Assessment and Treatment of Dyslipidemia

Why are blood lipid levels divided into different levels?

Total cholesterol starts at 3.6 mmol/L, and the risk of ischemic cardiovascular disease gradually increases with increasing levels. Because the relationship between total cholesterol (TC) levels and the risk of ischemic cardiovascular disease is continuous without a clear turning point, the cutoff point for diagnosing hypercholesterolemia must be artificially determined.

Studies have shown that when total cholesterol (TC) increases to 5.2–6.2 mmol/L (200–239 mg/dL), the risk of ischemic cardiovascular disease increases by approximately 50% compared to those with TC < 3.6 mmol/L (140 mg/dL). When TC rises above 6.2 mmol/L (240 mg/dL), the risk of ischemic cardiovascular disease increases by more than two times compared to those with TC < 3.6 mmol/L (140 mg/dL).

The stratification of dyslipidemia also involves other considerations. Atherosclerosis is influenced by other factors such as age, hypertension, diabetes, and smoking. Because these factors have a cumulative effect on atherosclerosis, a comprehensive evaluation of the patient is necessary after initial detection of elevated blood lipids. If a patient with dyslipidemia also has hypertension, diabetes, or smokes, the appropriate level of blood lipids must be reassessed. Different levels of dyslipidemia require different treatment strategies. Statins are the main lipid-lowering drugs, and their use can bring significant clinical benefits to intermediate- and high-risk individuals, but no benefit has been observed in low-risk individuals. Therefore, intermediate- and high-risk individuals require medication in addition to lifestyle interventions, while low-risk individuals should primarily rely on lifestyle interventions.

The main harm of dyslipidemia is the increased risk of developing atherosclerotic cardiovascular disease (ASCVD).