The Risks of Hyperlipidemia and How to Prevent It — Starting with How to Read Your Cholesterol Numbers

What hyperlipidemia is — start by reading your own numbers

Hyperlipidemia is a state in which the lipids in the blood (cholesterol and triglycerides) are higher than normal. It is diagnosed by a blood test after fasting for at least 12 hours, and the generally accepted standards are as follows (mg/dL).

• Total cholesterol — under 200 is normal, 200–239 is borderline, 240 and above is high
• LDL cholesterol ("bad" cholesterol) — under 130 is within the normal range, and 160 and above is high. People at high cardiovascular risk are advised to manage it even lower
• HDL cholesterol ("good" cholesterol) — this one is the opposite: the lower it is, the greater the risk. Under 40 is on the low side, and 60 and above is beneficial
• Triglycerides — under 150 is normal, 150–199 is borderline, 200 and above is high

The point is "LDL and triglycerides low, HDL high." Rather than throwing away your health check-up results, making it a habit to check at least these four numbers is the starting point of management.

Why it is dangerous — it progresses in silence

Excess cholesterol builds up on the vessel walls as plaque (clumps of fatty residue). As atherosclerosis—the narrowing and hardening of the vessels—progresses, the outcome differs depending on where it occurs.

• If the heart's vessels become blocked: angina or heart attack
• If the brain's vessels become blocked: cerebral infarction (stroke)
• If the leg's vessels become blocked: peripheral artery disease, which causes pain when walking

In particular, if triglycerides are extremely high (roughly 500 and above), it can even trigger acute pancreatitis. The frightening part is that most of this process progresses without symptoms over several years. That is why "I have no pain, so I'm fine" is the most dangerous misconception.

Who needs to be more careful

The more of the following that apply, the higher the risk. If even one applies, it is good to attend more closely to managing your numbers.

• A diet high in saturated and trans fats, frequent drinking, lack of exercise
• Abdominal obesity, smoking
• Age (men 45 and older; for women, risk increases after menopause)
• Family history — if a parent or sibling has hyperlipidemia or early cardiovascular disease
• Accompanying conditions such as diabetes or hypothyroidism

"I'm thin, so I'm fine" is a common misconception. Because of genetics or eating habits, even a lean person can have high LDL, so you should not be reassured by body type alone.

Prevention and management — what actually needs to change

Most borderline to mild stages can improve meaningfully with lifestyle correction alone. The key is the following five things.

• Diet — Start by cutting the saturated fat in pork belly fat, butter, and processed meats, and the trans fat in margarine, fried foods, and processed foods. Instead, fill up with whole grains such as oats and barley, legumes, vegetables and fruit, oily fish (mackerel, salmon), and nuts. In particular, the soluble dietary fiber in oats and barley is known to help with cholesterol management. Also reduce the simple sugars in sweet drinks and snacks, which raise triglycerides
• Aerobic exercise — Brisk walking, jogging, or cycling for at least 30 minutes a day, 3–5 times a week. It is especially effective at raising HDL and lowering triglycerides
• Weight management — In many cases, just reducing abdominal obesity brings the numbers down along with it
• Quitting smoking and moderating alcohol — Smoking lowers HDL and damages the vessels. Alcohol also raises triglycerides significantly
• Regular check-ups — Since there are no symptoms, there is no way but to confirm with numbers. Make use of the blood test in the national health check-up, and if you are in a high-risk group, measure more frequently

A cholesterol-lowering table — change it like this

Rather than the abstract "cut back on greasy things," it is faster to change things at your actual table. Try replacing them one by one with "the same situation, a better choice," as below.

• Morning white bread or cereal → multigrain rice mixed with oats and barley or oatmeal (soluble dietary fiber helps reduce cholesterol absorption)
• Pork belly or processed meat (ham, sausage) → oily fish such as mackerel and salmon, or chicken breast, beans, tofu
• Fried foods, margarine, cream → baking or boiling; use a small amount of olive oil for fat
• Instant coffee mix, soda, snacks → water or unsweetened tea; for a snack, a handful of nuts (a small amount per day)
• Salty ramyeon and broth → season lightly. Sodium affects your blood pressure too

On top of this, the surest way to raise HDL ("good" cholesterol) is aerobic exercise and quitting smoking. These are basics to do before medication—and to keep up alongside it even if you do take medication.

When you should go to the hospital

If your numbers do not come down well after keeping up lifestyle changes for a few months, if they are very high from the start, or if risk factors such as diabetes or cardiovascular disease overlap, you need a specialist consultation. In such cases a doctor may assess your risk and consider drug therapy, but the type of drug and whether to take it must be decided through a doctor's care. If you are already taking prescription medication, do not stop it on your own—consult your treating physician.

Frequently asked questions

Q. Is cholesterol unconditionally bad?

No. The lower LDL and triglycerides, the better, but HDL is actually more beneficial the higher it is. The key is "keep the bad low, keep the good high."

Q. Can it improve with exercise and diet alone?

At the borderline to mild stage, it often improves meaningfully with lifestyle correction alone. However, if the numbers are very high or there are many risk factors, medical evaluation is needed.

Q. Do I really need to get tested even though I have no symptoms?

Yes. Hyperlipidemia usually has no symptoms and can only be detected by testing. By the time symptoms appear, it has often already progressed to complications, so regular check-ups are important.

This article provides general health information and is not a substitute for medical diagnosis or treatment. The numeric standards presented are general ranges to aid understanding and may be interpreted differently depending on the testing institution and individual condition; diagnosis, treatment, and taking medication must be decided in consultation with a doctor.