Dyslipidaemia
High LDL / triglycerides, low HDL leads to atherosclerotic cardiovascular disease
Evidence that reducing LDL improves mortality (but not for Rx triglycerides/HDL)
Severe hypertriglyceridaemia (>10) also predisposes to pancreatitis, this risk reduces with treatment
Screen for secondary causes
diabetes
Hypothyroidism
Screen for other CV risk factors
HTN
Smoking
Optimise other protective lifestyles: Diet, Exercise, OH,
Rx Familial hypercholesterolaemia
Low fat diet
Statins (HMG-CoA reductase inhibitors, limits synthesis in the liver, thereby stimulating the production of more LDL receptors on the cell surface)
Nicotinic acid (reduces hepatitic VLDL synthesis)
Fibrates (Activate peroxisome proliferator-activated nuclear receptors and modulate lipoprotein synthesis and catabolism)
Evolocumab (human monoclonal antibody: inhibits PCSK9 degradation of LDL receptors)
Omega-3-acid ethyl esters
Check lipids 6weekly during dose titration
Check lipids 6monthly once established
Evidence that reducing LDL improves mortality (but not for Rx triglycerides/HDL)
Severe hypertriglyceridaemia (>10) also predisposes to pancreatitis, this risk reduces with treatment
Screen for secondary causes
diabetes
Hypothyroidism
Screen for other CV risk factors
HTN
Smoking
Optimise other protective lifestyles: Diet, Exercise, OH,
Rx Familial hypercholesterolaemia
Low fat diet
Statins (HMG-CoA reductase inhibitors, limits synthesis in the liver, thereby stimulating the production of more LDL receptors on the cell surface)
Nicotinic acid (reduces hepatitic VLDL synthesis)
Fibrates (Activate peroxisome proliferator-activated nuclear receptors and modulate lipoprotein synthesis and catabolism)
- Fenofibrate
- Gemfibrozil
- Cholestyramine
- Colestipol
Evolocumab (human monoclonal antibody: inhibits PCSK9 degradation of LDL receptors)
Omega-3-acid ethyl esters
Check lipids 6weekly during dose titration
Check lipids 6monthly once established