Hyperlipidaemia Flashcards
What is hyperlipidaemia?
Hyperlipidaemia is a condition characterised by elevated levels of lipids (cholesterol and/or triglycerides) in the blood.
What are the main types of hyperlipidaemia?
Primary (genetic) hyperlipidaemia and secondary hyperlipidaemia due to underlying conditions or lifestyle factors.
What are the common causes of secondary hyperlipidaemia?
Causes include diabetes, hypothyroidism, obesity, chronic kidney disease, excessive alcohol consumption, and certain medications.
What is the pathophysiology of hyperlipidaemia?
It involves the accumulation of lipids in the blood due to increased production, decreased clearance, or both, leading to atherosclerosis.
What are the risk factors for hyperlipidaemia?
Poor diet, sedentary lifestyle, obesity, smoking, family history of hyperlipidaemia, and conditions like diabetes and hypothyroidism.
What are the clinical features of hyperlipidaemia?
It is often asymptomatic but may present with xanthomas, xanthelasma, corneal arcus, or symptoms of cardiovascular disease.
What are xanthomas, and how are they related to hyperlipidaemia?
Xanthomas are lipid deposits in the skin or tendons, commonly associated with severe hyperlipidaemia.
What investigations are used to diagnose hyperlipidaemia?
Lipid profile (total cholesterol, LDL, HDL, triglycerides), liver function tests, thyroid function tests, and fasting glucose or HbA1c.
What is the significance of LDL cholesterol in hyperlipidaemia?
LDL cholesterol is considered the “bad” cholesterol and is a key target in reducing cardiovascular risk.
What is familial hypercholesterolaemia?
A genetic disorder characterised by significantly elevated LDL cholesterol levels and increased risk of early-onset cardiovascular disease.
How is familial hypercholesterolaemia diagnosed?
It is diagnosed using clinical criteria such as Simon Broome or Dutch Lipid Clinic Network criteria, supported by genetic testing.
What are the complications of untreated hyperlipidaemia?
Complications include atherosclerosis, myocardial infarction, stroke, and peripheral arterial disease.
What are the management goals for hyperlipidaemia?
To lower LDL cholesterol levels, reduce cardiovascular risk, and manage associated comorbidities.
What lifestyle modifications are recommended for hyperlipidaemia?
A healthy diet low in saturated fats, regular physical activity, smoking cessation, weight loss, and limiting alcohol intake.
What is the first-line medical treatment for hyperlipidaemia?
Statins, such as atorvastatin or simvastatin, are the first-line therapy for lowering LDL cholesterol.
How do statins work?
Statins inhibit HMG-CoA reductase, reducing cholesterol synthesis in the liver and lowering LDL levels.
What are common side effects of statins?
Muscle pain, fatigue, liver enzyme abnormalities, and, rarely, rhabdomyolysis.
What are alternative lipid-lowering therapies if statins are not tolerated?
Ezetimibe, bile acid sequestrants, PCSK9 inhibitors, or fibrates may be used.
What is the role of fibrates in hyperlipidaemia management?
Fibrates lower triglycerides and can modestly increase HDL cholesterol.
How are triglycerides managed in hyperlipidaemia?
High triglycerides are managed with lifestyle changes, fibrates, or omega-3 fatty acid supplements if necessary.
What is the role of PCSK9 inhibitors in hyperlipidaemia?
PCSK9 inhibitors, such as evolocumab, significantly lower LDL cholesterol and are used in high-risk patients.
What is the QRISK score, and how is it used in hyperlipidaemia?
The QRISK score estimates the 10-year risk of cardiovascular events, guiding decisions on starting lipid-lowering therapy.
What are the treatment thresholds for starting statins in hyperlipidaemia?
Statins are typically recommended for patients with a QRISK score ≥ 10%, established cardiovascular disease, or familial hypercholesterolaemia.
How is hyperlipidaemia monitored during treatment?
Lipid profiles are checked 3 months after initiating therapy, and adherence to lifestyle changes and medications is reviewed regularly.
