Dyslipidemia

Question 1

What are normal lipid panel values?

Answer 1

Total CHO: < 200 mg/dL
LDL: < 100 mg/dL
HDL: > 40 mg/dL
Tri: < 150 mg/dL

Question 2

According to the 2018 AHA/ACC dyslipidemia guidelines, what are the four groups who should be treated and what are the corresponding target LDL reduction percentages with statin treatment?

Answer 2

Group: Target LDL reduction with statin:

History of CHD/MI or Stroke 50%

LDL > 190 mg/dL 50%
(familial HLP)

DM, age 40 - 75, 30% - 49%
LDL 70 - 189 mg/dL

ASCVD 10-year risk score >/= 7.5%. 30% - 49%
(primary prevention)

Question 3

How should triglycerides less than 500 be treated?

Answer 3

Lifestyle modifications:
- exercise
- diet, especially reduced alcohol and carbohydrate consumption
(Note: low HDL and high Tri usually = insulin insensitivity)

Statins (if otherwise indicated)
- will decrease tri by about 15%

Question 4

How should triglycerides greater than or equal to 500 be treated?

Answer 4

Fibrates:
- Fenofibrate (tricot, fibricor, etc.)
- Gemfibrozil (lopid)