Hyperlipidemia General Info Flashcards
How do we optimize the prevention of heart disease?
Lipid-lowering drugs combined with diet changes and exercise
Main HD risk profiles from a lipid standpoint
- Most cholesterol is carried in LDL particles
- Increased TGs and decreased HDL also a risk factor
- Trans Fat Acids (TFAs)
Components of Hyperlipidemia prevention
- Exercise
- Mediterranean diet has the best data (DON’T advocate for that stupid stupid “low-fat diet”)
Historically we have classified lipoprotein abnormalities into what two groups?
- Increased LDL
2. Combined dyslipidemia: Low HDL, high TG, high non-HDL, and normal LDL
The new approach for LDL targets is NOT based on specific LDL goals. What is the focus?
- Statin trials used specific doses; they didn’t titrate to a specific LDL goal
- New focus is on an LDL % reduction
Focus is on more statin use and less use of non-statins
ACC/AHA CVD Risk Calculator purpose
- Determines patients 10-year risk of AMI or CVA based on sex, race, total, and HDL cholesterol, DM, systolic BP, HTN, smoking status
- PRIMARY PREVENTION
“High Intensity” Statins
-Lower LDL by >50%
- Rosuvastatin
- Atorvastatin***
Moderate Intensity Statins
-Lower LDL by 30-49%
- Rosuvastatin
- Atorvastatin
- Literally all the other statins
The guidelines recommend treating LDL in what patients?
- Clinical ASCVD
- DM
- LDL >190
- 10-year ASCVD risk >20%
- 10-year ASCVD risk of 7.5-19.9% in the presence of RF or mild coronary artery calcium
Common causes of secondary hyperlipidemia?
- Meds
- Hypothyroidism
- Obstructive biliary disease
- nephrotic syndrome
-Always rule these out if the initial LDL evaluation is >190
Lipid screening in pediatrics
universal lipid screening at 9-11 years & again at 17-21
Drugs that target LDL
- Statins
- Cholesterol absorption inhibitors
- bile acid sequestrants
- PCSK9 inhibitors
- ACL inhibitors
