hyperlipidaemia Flashcards
lipid transport
lipids travel the blood packaged with proteins as lipoproteins
4 classes:
chylomicrons and VLDL (mainly triglyceride)
LDL (mainly cholesterol)
HDL (mainly phospholipid)
risk factors
FHx of hyperlipidamia
corneal arcus <50yo
xanthomata or xanthelasma
common primary hyperlipidaemia
70% of all
raised LDL
familial primary hyperlipidaemias
comprise multiple phenotypes
greatly increase the risk of CVD
evidence suggests that protection gained from statins can be achieved at lower doses than common primary
secondary hyperlipidaemia
may be caused by: cushing's syndrome hypothyroidism nephrotic syndrome cholestasis
high LDL
treat underlying cause first
mixed hyperlipidaemia
increase in both LDL and triglycerides
caused by: T2DM, metabolic syndrome, alcohol abuse, chronic renal failure
management
lifestyle advice:
BMI 20-25, diet with <10% calories from saturated fats, omega 3, exercise
1st line:
statins eg simvastatin, which decrease cholesterol synthesis in the liver
CI: pregnancy, porphyria, cholestasis
SE: myalgia and mysositis
2nd line:
fibrates eg bezafibrate or cholesterol absorption inhibitors eg ezetimibe