Epidemiological investigations have shown that elevated serum cholesterol levels are positively correlated with atherosclerosis. Its incidence is positively correlated with serum cholesterol, negatively correlated with HDL-C, and the relationship with serum triglycerides is inconclusive. The initial stage of atherosclerosis begins with damage to endothelial cells for unknown reasons. In hyperlipidemia, various lipoproteins are retained in the blood, during which lipid peroxidation may occur and participate in endothelial cell damage. The presence of oxidized lipoproteins within atherosclerotic foci was demonstrated with antibodies to oxidized lipoproteins; clinical use of antiperoxidant drugs resulted in smaller lipomas in patients with familial hypercholesterolemia. Studies have shown that the peroxidation of hyperlipidemia or lipoproteinemia is closely related to the genesis of atherosclerosis. Types of primary hyperlipidemia: The main types of primary hyperlipidemia are as follows: primary hyperlactatemia; familial hypercholesterolemia; familial complex hyperlipidemia; endogenous hypertriglyceridemia; familial type III hyperlipidemia; and primary hyperHDLemia. Risk factors for atherosclerosis: primary hyperlipidemia is one of the risk factors for ischemic heart disease, and most myocardial infarctions present with hyperlipidemia accompanied by reduced HDL-C. Atherosclerosis in general is a disorder of genetic factors plus acquired factors. Atherosclerosis is associated with insulin resistance and abnormal glucose tolerance, and factors such as hyperinsulinemia, hyper-VLDLemia, reduced HDL-C, and hypertension belong to the concept of metabolic syndrome X. Some foreign scholars proposed that upper body obesity, abnormal glucose tolerance, hyperlipidemia and hypertension are the fatal quadruple attitude. These factors interact and promote each other, which can accelerate the formation of atherosclerosis, and it may not be statistically significant to single out a factor for consideration. For example, if insulin resistance alone is considered, the theory of metabolic syndrome X and the fatal quartet is unlikely to be valid. The metabolic disorder of excessive accumulation of adipose tissue alone is not directly related to hyperlipidemia and hypertension, but simply belongs to the abnormal fat distribution syndrome. Only in the presence of insulin resistance is it considered to belong to metabolic syndrome X and fatal quadruplex associated with the development of atherosclerosis.