Hypercholesterolaemia Flashcards
How is familial hypercholesterolaemia inherited?
Autosomal dominant
What is the concern in famlial hypercholesterolaemia
- high levels of LDL-cholesterol
=> early cardiovascular disease (CVD)
When should familial hypercholesterolaemia be suspected?
total cholesterol >7.5 mmol/l
FHx premature coronary heart disease
how soon should children be screened for FH if they have a relative with the condition?
children of affected parents:
if one parent is affected
> by age 10
both parents affected
> by age 5
What is the diagnostic criteria for FH?
ADULT:
total cholesterol > 7.5 mmol/l LDL > 4.9 mmol/l
CHILD
TC > 6.7 mmol/l
LDL > 4.0 mmol/lplus:
Management of FH
- Referral to specialist lipid clinic
- high-dose statins
When are fibrates used?
- management of hyperlipidaemia
- particularly raised triglycerides.
How do fibrates work?
Activating PPAR alpha receptors
=> increase in LPL activity reducing triglyceride levels.
Side effects of fibrates
gastrointestinal side-effects are common
increased risk of thromboembolism
How does ezetimibe work?
inhibits cholesterol receptors on enterocytes
=> reduces cholesterol absorption in the small intestine.
When is ezetimibe used as monotherapy?
- primary hypercholesterolaemia - statin therapy is contraindicated
- OR cannot tolerate statin therapy
When is ezetimibe used as an adjunct therapy alongside statins?
- serum total or LDL cholesterol is not controlled
