HDL And HTN Flashcards
CAC score
Amount of calcium build up on inner lining of the heart
Over 400 = severe
Hyperlipidemia
Increased lipids in the blood
Dyslipidemia
Abnormal amount, higher or lower of cholesterol in the blood
Normal Lipid panals
T : <200
LDL < 120
HDL >55
Tri : 30-150
Secondary causes of HLD
Diuretics, glucocorticoid steriods, nephrotic syndrome, hypothyroidism , pregnancy
Statin administeration guide
When indication is high statin — start with moderate and then increase after 4-6 weeks
When to recheck LDL
Measure 6 weeks after initiation of therapy and every 6-12 months there after
Muscle symptoms - what do you do
Stop and assess for Rhabdomyolsis
Muscle weakness, muscle pain and dark urine
Rechallenge with lower or same dose of statin
Re- challenge with a statin that uses a different pathway
If can tolerate moderate statin - refer
High intensity statin
Lower LDL by > 50 %
- Atorvastatin (Lipitor) 40-80mg
- Rosuvastin (Crestor) 20-40 mg
Age 21 - 75 years with clinically evident ASCVD – MI, unstable angina, stroke, TIA, PAD
Age 21 or older with LDL of ≥190 mg but without evidence of ASCVD (consider genetic or secondary causes)
Moderate intensity statin
Lower LDL by 30-50 %
Atorvastatin 10-20mg
Rosuvastin 5-10
Simvistatin 20-40
Age 40 – 75 with Diabetes and LDL ≥ 70
Age 40 – 75 w/LDL – C 70 – 189 mg and estimated 10 year risk ASCVD ≥ 7.5%
Low intensity Statin
lower LDL by < 30 %
Simvistatin - 10 mg
Pravasatin -10-20 mg
Chronic liver disease
Use statins very caiutiously
All statins are metabolized in liver
Use Pravastatin and Rosuvastatin
Monitor ALT 4- 12 weeks
Chronic Kidney Disease
Atorvastin and Fluvastatin
Cause they do not require dose adjustments
Nictonic Acid
Used to lower TRI and increase HDL
SE; Itching, flushing, tingling, hepatoxicity
Fibrates
Lower tri and increase HDL
SE; gallstones and dyspepsia
Bile Acid Sequestrants
Interfere with fat absorption, lower LDL , for people who can not tolerate statins
Bloating, flatulence, abdominal pain
PCSK9 Inhibitors
Targets and inactivates protein in the liver that helps to decrease LDL
Subcutaneous injection ( biweekly)
Cholesterol absorption inhibitors
Reducing absorption of cholesterol from the intestine, does not reduce tri
Diarrhea, abdominal pain, joint pain
Treatment for triglycerides
Lifestyle, determine if familiaral, address other diseases ( hypothyroidism )
Observe for pancreatitis
Fibrates and Nictininic Acid
Organ damage of HTN
Brain - CVA, encephalopathy
Blood : elevated BS
EYE; rentinopathy
Heart : MI, HF
Kidneys: Nephopathy CKD
BP
CO X systemic vascular resistance
- sympathies nervous system
- Renin - angiotensin- aldosterone
- plasma volume largely mediated by kidneys
Normal BP
120/80
Elevated BP
120-129 / 80
Stage 1 HTN
130-139 / 80-89
