Hypercholesterolaemia

Question 1

Define hypercholesterolaemia.

Answer 1

Hypercholesterolaemia, an elevation of total cholesterol (TC) and/or low-density lipoprotein cholesterol (LDL-C) or non-high-density lipoprotein cholesterol (HDL-C).

Question 2

Explain the aetiology/risk factors of hypercholesterolaemia.

Answer 2

Insulin resistance and type 2 diabetes mellitus
Excess body weight (body mass index >25 kg/m²)
Hypothyroidism
Cholestatic liver disease

Question 3

Summarise the epidemiology of hypercholesterolaemia.

Answer 3

Approximately 28.5 million adults or nearly 12% of the adult population in the US have total cholesterol levels ≥6.2 mmol/L (≥240 mg/dL).

Question 4

Recognise the presenting symptoms of hypercholesterolaemia. Recognise the signs of hypercholesterolaemia on physical examination.

Answer 4

Family history of early onset of coronary heart disease or dyslipidaemia in first-degree relatives
History of cardiovascular disease
Excess body weight (especially abdominal obesity)
Xanthelasmas
Corneal arcus

Question 5

Identify appropriate investigations for hypercholesterolaemia and interpret the results.

Answer 5

Lipid profile
Serum thyroid-stimulating hormone (TSH)
Lipoprotein(a)

Question 6

Generate a management plan for hypercholesterolaemia.

Answer 6

Statins
Lifestyle modifications
Can use ezetimibe or PCSK9 inhibitor

Question 7

Identify the possible complications of hypercholesterolaemia and its management.

Answer 7

Ischaemic heart disease
Peripheral vascular disease (PVD)
Acute coronary syndrome
Stroke
Erectile dysfunction

Question 8

Summarise the prognosis for patients with hypercholesterolaemia.

Answer 8

If the treatment plan includes detection and management of other factors that contribute to the development of coronary heart disease (CHD), such as hypertension, diabetes mellitus, and smoking, the overall prognosis of hypercholesterolaemia is improved.