Hyperlipidemia Patho and Patient Assessment Flashcards
Cholesterol
Soft,lipid substance
Too much cholesterol leads to the development of artherosclerotic plaques because it has no where to go
Lipoprotein
Used in the transport of lipids through the extracellular fluid around the body
Triglycerides(TG)
- Excess energy stored within fat cells in body
- Used as energy source between meal proteins
Very low density lipoproteins(VLDL)
- Composed of a majority of TGs
Intermediate Density Lipoproteins(IDL)
- Formed from VLDL degradation, precursor to LDL synthesis
Low Density Lipoproteins(LDL)
- ApoB is the major component of LDL
Lp(a)
Contributes to artherosclerosis by inhibiting thrombolysis
High Density Lipoproteins(HDL)
ApoA the major component of HDL
Lipid Panel
- Laboratory test
- Ideally after a 9-12 hour fast
- Draw 4-12 weeks after initiation or change in lipid lowering therapy
Non-HDL equation
Non-HDL=TC-HDL
Hyperlipidemia
Includes metabolic disorders that involves an elevation in any lipoprotein species
Major sequela–>artherosclerosis
Hyperlipemia
Increased triglyceride levels
Major sequela–>pancreatitis
Cholesterol Panel
- Low density lipoprotein—>Carries lipids from the liver to tissues
- High Density lipoproteins–>Carries excess lipids to the liver for elimination
- Triglycerides–>Type of fat transported in the bloodstream and stored in fat
Atherosclerosis
“Hardening of the arteries”
- Chronic,lipid driven inflammatory disease of the arterial wall leading to plaque
- Cause of most CVD events
Artery Layers
- Intima
- Media
- Adventitia
Endothelial cells lining intravascular walls, maintain structural metabolic, and signaling functions to maintain homeostais
What impacts the lipid panel and atherosclerosis?
- Cigarette smoking
- Diabetes
- Hypertension
Cigarette smoking
- Reduces HDL
- Impacts cholesterol retrieval, increases oxidation of lipoproteins
- Cytotoxic effects to endothelium
- Increases thrombogenesis
Diabetes
Major source of oxidative stress
Hypertension
Increases atherosclerotic cardiovascular disease
How do we determine if/when to treat a patient?
- Clinical ASCVD
- ASCVD Risk Score
- Lipid Panel
- Coronary Artery Calcium Score
Secondary prevention
Once clinical ASCVD is established, patients recieve lipid lowering therapy
ASCVD Risk Score
- Calculated for patients who have NOT had an ASCVD event
- Determines risk of having an ASCVD event
- Can calculate a 10-year and lifetime risk
Primary Prevention
Calculate an ASCVD risk in all patients 40 years and older who have NOT had an ASCVD event to determine if lipid lowering therapy is necessary
Coronary Atrtery Calcium Score(CAC)
CT scan that measures the amount of calcified plaque in the coronary arteries
