Dyslipidemia Flashcards
peripheral arterial disease
a condition in which narrowed arteries reduce blood flow to the extremities, typically the legs, due to atherosclerosis, leading to symptoms like pain, cramping, and impaired circulation.
Pooled Cohorts Equations are
race-and sex-specific equations used to predict a 10-year ASCVD risk and work best in individuals of age 40-75 years who have no history of ASCVD, severe hypercholesterolemia, or diabetes.
hypercholesterolemia
a medical condition characterized by abnormally high levels of cholesterol in the blood, increasing the risk of atherosclerosis and cardiovascular disease.
If atherosclerosis occurs in the coronary artery, it can result in
stable angina and ACS
ACS includes
unstable angina and myocardial infarction
If atherosclerosis occurs in the brain artery, then it can cause
ischemic stroke or TIA (Transient ischemic attack)
If atherosclerosis occurs in the major arteries in the limbs, then it can lead to
peripheral arterial disease, also called peripheral vascular disease.
reducing the risk for ASCVD is the main goal of
lipid-lowering therapy. This means that we determine the need for lipid-lowering therapy based on the individual’s risk for ASCVD, not just based on the individual’s blood lipid levels.
What is the primary reason for prescribing lipid-lowering therapy in a patient with a history of ASCVD?
Lipid-lowering therapy is prescribed to prevent the recurrence of ASCVD in patients with a history of the condition.
When is lipid-lowering therapy recommended for a patient with severe hypercholesterolemia (LDL cholesterol of at least 190) even if they have no history of ASCVD?
Lipid-lowering therapy is recommended for severe hypercholesterolemia, even without prior ASCVD, due to the high risk of developing ASCVD.
Why are patients with diabetes considered to have an increased risk of ASCVD?
Patients with diabetes are at an increased risk of ASCVD, which is why they are candidates for lipid-lowering therapy.
How is the need for lipid-lowering therapy determined for individuals who haven’t had ASCVD, don’t have severe hypercholesterolemia, or diabetes?
For those without ASCVD, severe hypercholesterolemia, or diabetes, the need for lipid-lowering therapy is determined by predicting their ASCVD risk using Pooled Cohorts Equations.
What do the Pooled Cohorts Equations predict, and why are they used?
Pooled Cohorts Equations predict a 10-year risk of fatal and non-fatal MI and ischemic stroke, which are part of ASCVD. They are used to assess the need for lipid-lowering therapy.
Why are the equations called “Pooled Cohorts”?
The equations are called “Pooled Cohorts” because they were derived from data compiled from 5 community-based cohorts representing the US population.
What patient factors are used in the Pooled Cohorts Equations to predict ASCVD risk?
The Pooled Cohorts Equations use age, sex, race, systolic blood pressure, total cholesterol, HDL-cholesterol, diabetes status, smoking status, and hypertension treatment status as variables to predict a 10-year risk of ASCVD.
How can a healthcare provider determine the right Pooled Cohorts Equation for a patient’s specific sex and race?
The American College of Cardiology has a website that can automatically select the appropriate equation based on the patient’s specific sex and race.
What are the four risk categories based on the 10-year risk of ASCVD?
- low risk (less than 5%)
- borderline risk (5% to less than 7.5%)
- intermediate risk (7.5% to less than 20%)
- high risk (at least 20%).
What are the limitations of the Pooled Cohorts Equations in predicting ASCVD risk?
- being less accurate for individuals who are not non-Hispanic whites or blacks
- those younger than 40 or older than 75
- the dominance of age in risk scoring, potentially overestimating risk in the elderly.
Why can advanced age alone lead to a high-risk classification, according to the Pooled Cohorts Equations?
Age dominates risk scoring in the equations, and advanced age can lead to a high-risk classification even if other variables are not significant.
What important risk factors for ASCVD are not included in the Pooled Cohorts Equations?
The equations do not include all known risk factors for ASCVD, such as chronic inflammatory diseases and family history.
What should be investigated for the treatment of hyperlipidemia, and what are some secondary causes to consider?
Investigate secondary causes of hyperlipidemia, including medications, when treating hyperlipidemia.
What lifestyle therapies should be a part of any lipid-lowering treatment regimen?
- healthy diet
- regular exercise
- weight loss
How can lipid-lowering medications be classified, and what is the priority for treatment unless certain conditions exist?
can be classified as LDL-C-lowering and TG-lowering, with the priority being to lower LDL-C unless the patient has severe hypertriglyceridemia.
What is the main goal of lipid-lowering therapy, and which medications have been shown to reduce the risk of ASCVD?
The main goal of lipid-lowering therapy is to reduce the risk of ASCVD, and medications like statins, statin plus ezetimibe, statin plus a PCSK9 inhibitor, and statin plus icosapent ethyl have been shown to achieve this goal.