Lipids Flashcards
what is familial hypercholesteralaemia
AD condition causing high LDL cholesterol
when to suspect FH in adults
total cholesterol >7.5
personal or fam history of premature coronary heart disease
when to suspect FH in children
if parents affected
when to screen children for FH
if one parent affected - before 10
if two parents affected - before 5
what is the Simon Broome criteria for FH in adults
TC >7.5
LDL cholesterol >4.9
FH of tendon xanthoma = definite FH
FH of MI <50 = possible FH
Simon Broome criteria for FH in children
TC >6.7
LDL cholesterol >4
management of FH
referral to specialist lipid clinic
high dose statins
screen first degree relatives
when should statins be stopped in people with FH
pregnant women - stop 3 month before conception
what to give for primary prevention of CVD in patients with QRISK score >10%
atorvastatin 20 mg
what to give for secondary prevention of CVD in patients with known CVD
atorvastatin 80mg
when should QRISK score not be used
type 1 diabetics
CKD
familial hyperlipidaemia
what to give patients with a QRISK score >10% the option of before starting a statin
making life style changes and having their QRISK recalculated after a period of time
how is CVD prevented in type 1 diabetics
give atorvastatin if:
- older than 40
- have had diabetes for >10 years
- established nephropathy
- other CVD risk factors
what is the aim in reduction of HDL cholesterol to prevent CVD
40% reduction
adverse effects of statins
myalgia myositis rhabdomyelitis liver impairment risk of intracerebral haemorrhage
