Hyperlipidaemia Flashcards
What is hyperlipidaemia?
Hyperlipidaemia refers to raised levels of one or more of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) in the blood.
What is dyslipidaemia?
Dyslipidaemia is an umbrella term that includes hypercholesterolaemia, hyperlipidaemia, and mixed dyslipidaemia.
What is mixed dyslipidaemia?
In mixed dyslipidaemia, LDL-C and TG levels are elevated, often accompanied by low levels of high-density lipoprotein cholesterol (HDL-C).
What percentage of adults in England have serum cholesterol levels above 5 mmol/L?
Approximately 60% of adults in England have serum cholesterol levels above 5 mmol/L.
What is the prevalence of heterozygous familial hypercholesterolaemia (FH) in the UK?
Heterozygous familial hypercholesterolaemia has a prevalence of between 1 in 250 and 1 in 500 in the UK.
What is the incidence of homozygous familial hypercholesterolaemia?
Homozygous familial hypercholesterolaemia is rare, with an incidence of 1 in a million.
What are the primary causes of hyperlipidaemia?
Primary causes include genetic factors such as familial hypercholesterolaemia.
What are secondary causes of hyperlipidaemia?
Secondary causes include lifestyle factors (e.g., diet high in saturated fats), obesity, diabetes mellitus, hypothyroidism, nephrotic syndrome, and certain medications.
What are the common symptoms of hyperlipidaemia?
Hyperlipidaemia itself is typically asymptomatic but can lead to atherosclerotic complications like ischaemic heart disease, acute coronary syndrome, peripheral vascular disease, stroke, erectile dysfunction, and mesenteric ischaemia.
What physical signs might indicate hyperlipidaemia?
Physical signs can include xanthomas (cholesterol deposits in tendons), xanthelasma (cholesterol deposits around the eyes), and corneal arcus (cholesterol deposit in the cornea).
What is the first-line investigation for suspected hyperlipidaemia?
A lipid profile test measuring total cholesterol, LDL-C, HDL-C, and triglycerides.
What lifestyle modifications are recommended for managing hyperlipidaemia?
Recommendations include adopting a diet low in saturated fats, increasing physical activity, weight reduction, smoking cessation, and limiting alcohol intake.
What is the first-line pharmacological treatment for hyperlipidaemia?
Statins are the first-line pharmacological treatment, as they inhibit HMG-CoA reductase, reducing cholesterol synthesis.
What are some common side effects of statins?
Common side effects include muscle pain (myopathy), elevated liver enzymes, and, rarely, rhabdomyolysis.
What alternative medications can be used if statins are contraindicated or not tolerated?
Alternatives include fibrates, bile acid sequestrants, niacin, and PCSK9 inhibitors.
How often should lipid levels be monitored in patients with hyperlipidaemia?
Lipid levels should be monitored every 3 to 6 months initially, then annually once stable.
What is the target LDL-C level for high-risk patients?
For high-risk patients, the target LDL-C level is less than 2 mmol/L.
What role does HDL-C play in cardiovascular health?
HDL-C is considered “good” cholesterol; higher levels are associated with a lower risk of cardiovascular disease.
How does hyperlipidaemia contribute to atherosclerosis?
Elevated levels of LDL-C can lead to plaque formation in arterial walls, causing narrowing and increasing the risk of cardiovascular events.
What is the significance of triglyceride levels in hyperlipidaemia?
Elevated triglyceride levels are associated with an increased risk of pancreatitis and may contribute to cardiovascular disease.
What dietary components should be limited to manage hyperlipidaemia?
Limiting intake of saturated fats, trans fats, and cholesterol-rich foods is recommended.
How does physical activity influence lipid levels?
Regular physical activity can help increase HDL-C levels and lower LDL-C and triglyceride levels.
What is the impact of smoking on lipid levels?
Smoking lowers HDL-C levels and contributes to endothelial damage, increasing cardiovascular risk.
Why is it important to manage hyperlipidaemia in diabetic patients?
Diabetic patients are at higher risk for cardiovascular disease; managing lipid levels is crucial to reduce this risk.
What is the role of genetic testing in hyperlipidaemia?
Genetic testing can identify familial hypercholesterolaemia, allowing for early intervention and management.
