ABSTRACT
Dyslipidemia is characterized by an elevated low-density lipoprotein (LDL) cholesterol, a low high-density lipoprotein (HDL) cholesterol, and/or and elevated triglyceride level. Dyslipidemia may have genetic, secondary, and environmental causes. Population-based studies have shown a relationship between dyslipidemia and atherosclerotic cardiovascular disease (ASCVD). Randomized clinical trials with individuals on lipid lowering therapy, particularly statin medications, have shown a reduction in risk of major cardiovascular events and stroke. Lifestyle changes are important in the management of dyslipidemia especially when metabolic syndrome is present. A variety of dietary patterns have proven effective for improving lipid levels and reducing ASCVD risk. The evidence for the following dietary patterns is presented: reduced saturated fat, Mediterranean, carbohydrate restriction, vegetarian, and plant based. Research supporting the effect of select dietary supplements on lipid levels, i.e., red yeast rice, plant stanols/sterols, fiber, omega-3 fatty acids, is described. There is strong evidence for the benefit of aerobic exercise in improving lipid levels and reducing ASCVD risk. Avoiding tobacco use, limiting alcohol intake, and stress reduction are also very important in maintaining healthy lipid levels. Lifestyle intervention remains the cornerstone of cardiovascular disease prevention, even for patients with ASCVD who also require medication.
