L 21 & 22 Hyperlipidaemia 1 Flashcards
Hyperlipidaemia definition
Raised serum levels 1) total cholesterol,2) LDL 3) TGs.
Why are raised cholesterol levels a risk?
It increases the risk of atherosclerotic development
Just remember that There is variability of lipoprotein concentration between populations
Lipid concentrations
Māori are more than … as likely to die from CVD
More than twice as likely to die from CVD
What is the percentage of all deaths with hyperlipidemia in NZ?
17%
What is cardiovascular risk facrtors?
High blood pressure, abnormal lipids, smoking, unhealthy diet/obesity, physical inactivity, diabetes, age, family history, gender, ethnicity/race
What is the percentage of New Zealanders that have one modifiable risk factor for heart with hyperlipidemia?
90%
How to discuss CV risk with your patient
Define CV event
Modifiable vs non-modifiable risk factors
State in frequency not probability (e.g 15 out of 100 will experience a CV event in the next 5 years, rather than 15% chance of developing)
Cholesterol is ….soluble
NOT water soluble
For transport, cholesterol needs to be … Why?
Packaged and carried by lipoproteins as they are water soluble
What is cholesterol’s role in the body?
Maintaining cell membrane integrity and synthesis of bile acids and hormones
What are the 6 classes of lipoproteins?
- Chylomicrons
- Chylomicron remnants
- Very low-density lipoproteins
- Low-density lipoproteins
- Intermediate density lipoproteins
- High-density lipoproteins
How do the 6 classes of lipoproteins vary?
Vary in size and in density
Which lipoprotein is “good for humans”?
HDL and bad is LDL
What do lipoproteins contain?
TAG, cholesterol, phospholipids, and apolipoproteins (amphipathic proteins)
What are apoproteins?
They are the Components of lipoproteins. Based on apoproteins they contain we can differentiate that lipoprotein.
What do chylomicrons and VLDL do?
They deliver TAG to different cells in the body
What does LDL do?
It delivers cholesterol to cells in the body where it can be used, for the synthesis of membranes and steroid hormones
What does HDL do?
It Reverses cholesterol transport, Removes the excess cholesterol than bring that back again to the liver.
What is a primary dyslipidemia?
Genetically determined dyslipidemia but is also influenced by environmental factors.
What is secondary dyslipidemia?
It occurs with other disorders or as a result of other drug therapies. Can be treated if the underlying cause is treated.
Medications that can increase hyperlipidemia risk (x4)
(diuretics + beta-blockers), oral contraceptives, corticosteroids, ciclosporin.
Medical conditions that can increase hyperlipidemia risk (x6)
Diabetes Pregnancy Hypothyroidism Chronic renal failure Alcohol abuse Cardiac transplantation
Pathophysiology of atherosclerosis - 4x steps
- Migration and proliferation of smooth muscle cells
- Presence of Smooth muscle cells + fibroblasts secrete collagen, proteoglycans, elastin, and glycoproteins to create a fibrous cap about the necrotic tissue
- Presence of Atherosclerotic plaques: narrows blood vessels, therefore, reduces blood flow.
- Plaque ruptures: causing loss of endothelium and formation of a thrombus (clot)
What is the 1st step of atherosclerosis?
Migration and proliferation of smooth muscle cells
What is the 2nd step of atherosclerosis?
Smooth muscle cells + fibroblasts secrete collagen, proteoglycans, elastin, and glycoproteins to create a fibrous cap about the necrotic tissue
What is the 3rd step of atherosclerosis?
Atherosclerotic plaques narrow blood vessels, therefore, reduces blood flow.
What is the 4th step (complication) of atherosclerosis?
Plaque ruptures, causing loss of endothelium and formation of a thrombus (clot)
How do you determine a patient’s lipid levels?
they don’t have symptoms.
By doing a Blood test only
Hyperlipidemia contributes to a
Patients overall CV risk
