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Hyperlipidaemia

 
 
 
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Overview

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  • Diagnosis - when diagnosed, primary / secondary, lipid results
  • Management - lifestyle changes, medications
  • Complications - atherosclerotic complications, NAFLD
  • Causes of Hyperlipidaemia

  • Primary

  • Familial lipoprotein lipase deficiency
  • Familial hypercholestolaemia
  • Familial combined hyperlipidaemia
  • Familial dysbetalipoproteinaemia
  • Familial hypertriglyceridaemia
  • Secondary: Predominantly LDL

  • Hypothyroidism
  • Cholestatic liver disease
  • Nephrotic syndrome
  • Secondary: Predominantly TAGs

  • Obesity
  • Diabetes
  • Alcohol abuse
  • Chronic kidney disease
  • Drugs - corticosteroids, antipsychotics, immunosuppressants, protease inhibitors, oral contraceptive pill, hormone replacement therapy
  • Pregnancy

Complications

  • Complications of Hyperlipidaemia

  • Atherosclerosis

  • Ischaemic heart disease
  • Ischaemic stroke
  • Erectile dysfunction
  • Peripheral vascular disease
  • Other

  • Non-alcoholic fatty liver disease

Management

  • Heart Foundation Lipid Targets

  • Total cholesterol: <4.0
  • LDL cholesterol: <2.0 (<1.8 if very high risk)
  • HDL cholesterol: >1.0
  • Triglycerides: <2.0
  • Management Options

  • Non-Pharmacologic

  • Dietary changes
  • Fish oil supplementation
  • Exercise
  • Alcohol avoidance
  • Smoking cessation
  • Pharmacologic

  • Statins - atorvastatin, pravastatin, rosuvastatin, simvastatin
  • Fibrates - fenofibrate, gemfibrozil
  • Ezetimibe
  • PCSK-9 inhibitors - alirocumab
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