Pages Below:

Hyperlipidaemia

LDL & Total Cholesterol
- strong association between ↑ LDL or total cholesterol and coronary heart disease
- Framingham study - mild effect singly, magnified effect with additional risk factors, (also MRFIT (US))
HDL
- appear to protect against atheroma
VLDL
- weak link to cardiovascular risk
- very high level triglycerides (>6 mmol/l) → Pancreatitis, Retinal Vein Occlusion

Myocardial Infarction can alter for about 3 months so take within 48 hours

hypertriglyceridaemia alone
- polygenic hypertriglyceridaemia
- lipoprotein lipase deficiency
- apoprotein C deficiency
Hypercholesterolaemia alone
- familial hypercholesterolaemia
combined hyperlipidaemia
- polygenic combined hyperlipidaemia
- familial combined hyperlipidaemia
- remnant hyperlipidaemia

hypertriglyceridaemia
- <2.0 mml / l
  - none
- 2.0-6.0
  - advise on reduction of other factors
- >6.0 mmol
  - lipid-lowering diet
  - abstinence from alcohol
  - fibrates
hypercholesterolaemia
- primary prevention (total cholesterol >7.8 or >6.5 if 2 other major risk factors, LDL >6 or >5 respectively)
  - lipid lowering diet
  - HRT
  - statins
- secondary prevention (total >4.8, LDL >3.3)
  - statins
combined
- diet
- fibrates (gemfibrozil - Helsinki)
- cholestyramine (Lipid Research Clinics Trial)

[ Home ] [ Up ]