Hypercholesterol + Statins Flashcards
What is familial hyper cholesterol
AD
Resulting in high levels of LDL and early CVD disease
When do you suspect
Cholesterol >7.5
FH or personal of premature IHD <60
What criteria to Dx
Simon Broome
What is diagnostic
Total >7.5
LDL >4.9
Tendon xanthoma
How do you treat
Specialist lipid clinic
High dose statin = 1st line
What else can be used
Ezetimibe - lipid lowering drug if statin CI or not controlled
What else should you do
Screen relatives
Children at 10 if one parent or 5 if both parents
What causes hyperlipidaemia
DM Obesity Alcohl Chronic renal / liver Thiazide BB Unopposed oestrogen
What causes hyper cholesterol
Nephrotic
Cholestasis
Hypothyroid
What score is used to calculate risk
QRISK 2 or ASSIGN
What else should you do
Total cholesterol and HDL
What do you do before starting a statin
Full lipid profile
When do you follow up
3 months with full lipid
Increase dose if not fallen 40%
What are lifestyle factors
Diet Exercise - 150 minutes + 2 strength Weight loss Alcohol Quit smoking
What is given as primary prevention
Artovastatin 20mg OD
Who gets a statin as primary prevention
10 year CVS risk >20%
Type 1 DM
CKD <60
What DM
> 40
10 years
Nephropathy
Other RF
What is given as secondary prevention
Atorvastatin 80mg
Who gets 2 prevention
Known IHD / cerebrovascular / PAD
What is bad cholesterol
LDL
Triglycerides
What is good cholesterol
HDL
What is dangerous levels
Total = 5+ - If >8 need treatment with statin - If 5-8 can try diet control LDL = 3+ Triglycerides = 2.3+
What are SE of statin
LFT dysfunction
Rhabdomyolysis leading to AKI
Type II DM
Haemorrhage = rare
What do you do if patient on statin and has muscle pain
Stop
Check CK
How do you monitor when starting on statin
Baseline LFT and 3 months and 12 months
Lipid profile
