Flashcards in Hyperlipidemia Deck (13):
LDL = Total cholesterol - HDL - triglycerides/5
Cut off for elevated cholesterol?
Who are high-risk patients for Coronary heart disease? Target LDL?
1. Atherosclerotic vascular disease (20% risk of coronary events in 10 years)
LDL goal <100
Who are "very high risk" patients for coronary heart disease? Goal LDL?
Patients with established coronary heart disease plus
a) multiple risk factors
b) poorly controlled risk factor
c) recent acute coronary event
Coronary heart disease risk factors?
2. Hypertension (or patients on antihypertensives)
3. HDL 45 or women >55
5. Family history of premature coronary artery disease (men <65)
Strata for 10 year risk of cardiovascular events?
Low risk if <100
Primary versus secondary prevention?
Primary – decreasing risk in hypercholesterolemic patients without history of coronary heart disease
Secondary – reducing mortality in patients who have established cardiovascular disease
Ways to Prevent CHD?
1. Lifestyle modifications
2. If lifestyle modifications not enough: Statins
Statins: main therapeutic effects? Side effects? Monitoring?
Mainly lowers LDL (also lowers triglycerides and increases HDL); hepatic injury/myositis. Monitor LFTs and creatine kinase
Niacin: main therapeutic effects? Side effects? Address side effects by?
Mainly lowers triglycerides (lowers LDL and raises HDL). Flushing, tachycardia, Flushing relieved by aspirin
Bile acid resins: example? main therapeutic effects? Side effects?
Cholestyramine. Mainly lowers LDL (raises HDL). G.I. discomfort
Fibric acid derivatives: example? main therapeutic effects? Side effects? Monitoring?
Gemfibrozil. Mainly lowers triglycerides (increases HDL) gallstones and increased LFTs. Caution if used with statins