Dyslipidaemias Flashcards
What is meant by the term Dyslipidaemias?
Abnormal levels of lipids in blood stream leading to increased levels of TC and LDL.
What are the ideal levels of TC, HDL, LDL?
TC < 5.0mmol/L
HDL > 1.0mmol/L (Men) - 1.2mmol/L (Women)
LDL < 4.0mmol/L
What complications arise with the presence of Dyslipidaemias?
Dysregulation in lipid levels can lead to an increased risk of atherosclerotic cardiovascular disease.
What are the two classifications of Dyslipidaemias and the causes?
Primary (Familial Hypercholesterolaemia) - inherited metabolic disease where mutation affects LDL receptor gene leading to increased levels of LDL 2-3 times higher then normal
Secondary caused due to a number of disorders, dietary indiscretion and certain drug use.
What 5 modifiable risk factors can lead to Dyslipidaemias?
Diet high in saturated fat
Smoking
Obesity
High alcohol consumption
Lack of exercise
What 2 non-modifiable risk factors can lead to Dyslipidaemias?
Kidney/Liver Disease
Genetic predisposition
How is the diagnosis of Dyslipidaemias achieved? (Signs/Symptoms)
There are no symptoms present but it is diagnosed through a blood test showing lipid profile levels
What TC levels support the diagnosis of FH?
TC > 7.5mmol/L
What 5 common drug classes are used in the management of serum lipid levels (give examples)?
Statins (Atorvastatin)
Ezetimibe
Fibrates (Bezafibrate)
Bile acid sequestrant (Colesevelam)
PCSK9 inhibitor (Alirocumab)
What are the treatment goals in the management of serum lipid levels?
A reduction in LDL-C by atleast 50% from baseline
What is the initial drug offered for the treatment of FH by NICE?
NICE guidance suggest the initial drug should be Atorvastatin 20mg or Rosuvastatin 10mg
Which statin is preferred in certain situations and why?
Atorvastatin is preferred to Rosuvastatin in patients with risk of Rhabdomyolysis
If the initial drugs are contraindicated what are the following steps?
If statins are contraindicated then the next drug to use is Ezetimibe 10mg if this is again contraindicated then it would be between bile acid sequestrant, Fibrates and PCSK9 inhibitors.
