Flashcards in Hyperlipidemia Deck (22)
Mechanism of statin
b hydroxy b methylgutarl coenzyme A inhibitor (HMG-CoA) reductase inhibitor; most widely used med to lower LDL
Statins should be implemented in all patients with known cardiovascular disease (i.e. ASCVD; atherosclerotic cv disease) and/or with LDL greater than ____?
Statins should be implemented in patients with (what condition) and LDL cholesterol greater than _____?
Statins should be started n patients aged 40-75 with _____year CVD risk greater than or equal to ____% and LDL greater than _____
10 year; 7.5%, 70
Despite all these guidelines and recommendations; decision to start statin therapy should ultimately depend on....
individual risk factors
What tools are out there that can assess for coronary disease
QRISK, ASSIGN, QRISK2
Goal for HDL cholesterol
60 or greater
When to be concerned about low HDL
less than 40
Desirable, borderline, high total cholesterol
optimal, near optimal, borderline, high, very high LDL
GO BY 30s starting from 100!
secondary causes of dyslipidemia
DM, hypothyroidism, obstructive liver disease, chronic renal failure
how to work up secondary causes of dyslipidemia (labs)
fasting blood glucose, TSH, liver enzymes, creatinine level
What kinds of medications can increase cholesterol
progestins, anabolic steroids and corticosteroids
What are the cornerstone of all treatments of HLD
healthy diet, regular exercise, smoking cessation, weight control
Recommend a healthy diet for cholesterol management
Rich in fruits and veggies
whole-grain/high fiber foods
fish, especially oily fish at least twice a week
minimize added sugars and sugary beverages
low salt foods and low fat (especially trans-fat and saturated fats --> favor polyunsaturated fat)
adding in dietary soluble fiber may be beneficial
always offer to refer to dietician
In addition to lowering LDL, what added beneifts are there to statins?
reduce rates of coronary events, strokes, cardiac death, and all-cause mortality
If patient cannot tolerate statins, what's a good alternative?
Who should get evaluated for secondary causes of hyperlipidemia
Anyone with LDL over 190 or triglycerides over 500
Side effects of statins
myopathy, myalgia, increased liver enzymes
Which labs should be trended when starting statin therapy?
contraindications to statins
active/chronic liver disease, relative contraindication with cytochrome P-450 inibitors, cyclosporine, macrolides, antifungals