Lipid Lowering Agents Flashcards
What is the meaning of the term “dyslipidaemia”? Dyslipidaemia is primarily a disorder of what? What type of disorders are most dyslipidaemias?
Disordered lipid levels in the blood
Lipoprotein metabolism
Hyperlipidaemias
What characterizes hyperlipidemia?
Elevated plasma cholesterol or triglyceride levels
What are the primary forms of hyperlipidemia?
Chylomicronemia
Hypercholesterolemia
Type III Familial Dysbetalipoproteinaemia
Type IV Familial Hypertriglyceridemia
Type V Familial Mixed hyperlipoproteinemia
Combined hyperlipoproteinemia
Which diseases can cause secondary hyperlipidemia?
Diabetes mellitus, pancreatitis, renal disease, and hypothyroidism
What are the two classifications of hyperlipidaemias?
Primary and secondary
How may dyslipidemias be manifested?
- Elevation of Total Cholesterol (TC), Low-density Lipoprotein (LDL-C) cholesterol, and Triglyceride (TG) concentrations
- Decrease in High-density Lipoprotein (HDL-C) cholesterol concentration
What is the cause of primary hyperlipidaemias?
Familial inheritance
What is the clinical presentation of hyperlipidaemias dependent on?
Type and severity
What causes secondary hyperlipidaemias?
Various other diseases, including medications
What are some clinical manifestations of hyperlipidaemias?
- Skin manifestations (e.g. xanthomas)
- Deposits around the eyelid (xanthelasma)
- Corneal arcus
- Hepatic steatosis (fatty liver disease)
- Atherosclerotic cardiovascular diseases
- Carotid artery stenosis
Why do skin manifestations, like xanthomas, occur in hyperlipidaemias?
High levels of lipoproteins leak out of vessels
What are fat deposits around the eyelid called?
Xanthelasma
What is the deposition of lipids around the cornea called?
Corneal arcus
What is the clinical term for fatty liver disease, a potential result of hyperlipidaemias?
Hepatic steatosis
What are the most troublesome atherosclerotic cardiovascular diseases?
Coronary artery disease, stroke, and peripheral vascular disease
What are the steps of atherosclerotic plaque formation?
- Infiltration of LDL-C into arterial walls
- Entrapment of LDL-C in artery walls
- Modification of LDL-C
- Uptake of modified LDL-C by macrophages
- Foam Cell formation
- Fatty streak formation
- Conversion to fibrous plaques
What is considered a normal lipid profile for healthy individuals after a 9- to 12-hour fast?
- Total (serum) cholesterol: below 5.0 mmol/L (below 193 mg/dL)
- Non-HDL cholesterol: below 4.0 mmol/L (below 155 mg/dL)
- LDL cholesterol: below 3.0 mmol/L (below 116 mg/dL)
- HDL cholesterol: above 1.0 mmol/L for a man (above 39 mg/dL); above 1.2 mmol/L for a woman (above 46 mg/dL)
- TC:HDL ratio: Above 6 is considered high risk
What level of TC:HDL ratio is considered high risk?
> 6
What dietary modifications are recommended for managing hyperlipidemia?
- Decrease intake of saturated fats/cholesterol
- Increase proportion of mono (MUFA) and poly-(PUFA) unsaturated fatty acid (olive & vegetable oils)
- Food supplements: Omega-3-fatty acid, essential fatty acids (linolenic & linoleic acids), antioxidants
How much can dietary modification reduce total cholesterol?
10-15%
How does obesity affect lipid levels?
↑ TG, ↓ HDL-C & slight ↑ in TC & LDL-C
What BMI and waist circumference are recommended for managing hyperlipidemia?
BMI < 23 kg/m2 & waist circumference < 90 cm (male); <80 cm (female)
What rate of weight reduction is recommended per week for hyperlipidemia management?
0.5-1.0 kg
How does exercise aid in managing hyperlipidemia?
- Helps to burn excess calories
- Will help ↑ HDL-C & ↓ TG
- Aerobic exercise: brisk walking, jogging, cycling, swimming
- Should be regular & adequate (30-45 min per session 3x / week)