Treatment of Dyslipidemia at Our Clinic

What is dyslipidemia?

Dyslipidemia means abnormal levels of fats in the blood.

Atherosclerosis can progress even with few symptoms. Diet and activity are not the only factors: genetics, diabetes, thyroid disease and medicines can also contribute.

Please discuss abnormal health-check results with us even if you feel well. Treatment priorities depend on which lipid levels are abnormal.

• High LDL (bad) cholesterol — high LDL cholesterol or hypercholesterolemia
• High triglycerides (TG) — hypertriglyceridemia
• Low HDL (good) cholesterol — low HDL cholesterol

Treatment for high LDL cholesterol

Persistently high LDL cholesterol promotes atherosclerosis. Treatment aims to prevent coronary disease, such as a heart attack, and stroke caused by atherosclerosis.

Primary prevention means preventing a first episode of these diseases in someone who has not previously had them.

Secondary prevention means preventing recurrence in someone who has had coronary disease, such as a heart attack or angina, or an atherothrombotic or other atherosclerotic stroke. Stricter LDL cholesterol management is needed because recurrence risk is higher.

The same LDL result may call for different treatment targets depending on age, blood pressure, smoking, diabetes, kidney disease and medical history.

We review excessive intake of fatty meat and butter, encourage balanced meals including fish, soy foods and vegetables, suitable physical activity, stopping smoking and a healthy weight. LDL-lowering medicines are added when appropriate.

The Hisayama score in primary prevention

For eligible people aged 40–79, the Hisayama score estimates the 10-year risk of coronary disease and atherothrombotic stroke. It considers age, sex, blood pressure, glucose regulation, LDL and HDL cholesterol, and smoking. It is not used to calculate recurrence risk in secondary prevention.

In primary prevention, diabetes, chronic kidney disease (CKD) or peripheral arterial disease (PAD) places a person in the high-risk category without score calculation. Familial hypercholesterolemia (FH) and certain other inherited lipid disorders require separate management.

At our clinic, we review medical history and other conditions, use the score where appropriate, and discuss individual targets and treatment. We explain the assessment and care plan using a printable A4 report.

We value an initial assessment before treatment and continue to review results during treatment. We consider pretreatment values and medical history as well as current results, rather than adjusting treatment solely because the numbers have improved.

Treatment for high triglycerides

Triglycerides provide energy, but persistently high levels call for a review of lifestyle and possible underlying conditions.

Meals affect triglyceride levels, so we check whether the blood sample was taken fasting or after eating. Repeat testing under consistent conditions may be appropriate.

We review food intake, alcohol, weight gain, diabetes, thyroid disease and medicines, alongside LDL cholesterol and blood glucose.

For markedly high triglycerides, our clinic investigates the cause and provides treatment suited to your condition. We combine changes to diet, drinking habits and other lifestyle factors with medication when needed.

• Review overall food intake and avoid excessive sugary drinks, sweets and portions of carbohydrate-rich foods.
• Review alcohol intake and reduce or stop drinking according to your condition.
• Keep physically active within your abilities and work toward weight loss if overweight.

If HDL cholesterol is low

We review lifestyle and other test results. Physical activity, stopping smoking and weight management are important, alongside management of LDL cholesterol and triglycerides.

The goal is not simply to raise HDL cholesterol with medication. We assess the overall risk of atherosclerotic disease.

Follow-up after starting treatment

We review test results, how you feel, treatment effects, possible side effects and medicine interactions. The timing of tests and visits depends on your condition and medicines.

Please discuss treatment with us before stopping medication, even if your results improve. Bring your health-check results, medication list and previous blood-test results if available.

Frequently asked questions

Guideline references

Japan Atherosclerosis Society, ed. Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. Japan Atherosclerosis Society; 2022.

Page numbers below are the printed page numbers. Links open the corresponding page of the Japanese PDF; the PDF viewer's page number is two pages higher.

Discuss your health-check results with us

We review LDL cholesterol, triglycerides and HDL cholesterol together and discuss a treatment plan suited to you.