Hyperchylomicronemia (Type I Familial Dyslipidemia)
- Autosomal Recessive
- Lipoprotein Lipase Deficiency (LPL)
- Altered Apolipoprotein C-II (Apo C-II)
- Increased Chylomicrons
- Increased Cholesterol
- Increased Triglycerides
- Pancreatitis
- Hepatosplenomegaly
- No Increased Risk for Atherosclerosis
- Eruptive/Pruritic Xanthomas
- Milky White Appearance of Blood When Drawn
Familial Hypercholesterolemia (Type IIa Familial Dyslipidemia)
- Autosomal Dominant
- Defective or Absent LDL Receptors
- Defective Apolipoprotein B-100 (ApoB-100)
- Increased LDL
- Decreased HDL
- Type IIb also has Increased VLDL
- Accelerated Atherosclerosis
- Achilles Tendon Xanthomas
- Xanthelasma
- Corneal Arcus
Dysbetalipoproteinemia (Type III Familial Dyslipidemia)
- Autosomal Recessive
- Defective Apolipoprotein E (Apo E)
- Increased Chylomicrons
- Increased VLDL
- Premature atherosclerosis
- Tuberoeruptive xanthomas
- Palmar xanthomas
Hypertriglyceridemia (Type IV Familial Dyslipidemia)
- Autosomal Dominant
- Hepatic Overproduction of VLDL
- Related to Insulin Resistance
- Increased VLDL
- Increased Triglycerides (> 1000 mg/dL)
- Acute Pancreatitis
- Eruptive Xanthomas
- Increased Risk for Coronary Artery Disease (CAD)
- Increased Risk of Peripheral Vascular Disease
Hyperlipoproteinemia (Type V Dyslipidemia)
- Increased Cholesterol
- Increased VLDL
- Increased Chylomicrons
- Increased Triglycerides
- Increased Risk of Cardiovascular Disease
- Xanthomas
- Acute Pancreatitis
- Lipid Panel
- Lifestyle Changes
- Statins
- Fibrates
Hypercholesterolemia Disease
- Diabetes
- Smoking
- Family History
- Hypertension
- HDL < 40
- Men Older than 45 Years of Age
- Women Older than 55 Years of Age
- Atheromas
- Plaques in Blood Vessel Walls
- Tissue Ischemia
- Xanthomas
- Lipemia Retinalis
Hypercholesterolemia Risk Stratification
- 0 - 1 Risk Factors
- < 160 mg/dl LDL goal
- greater or equal to 2 Risk Factors and 10-year Risk ≤ 20%
- < 130 mg/dL LDL Goal
- Coronary Heart Disease OR >/= to 2 Risk Factors AND 10-Year Risk > 20%
- < 100 mg/dL LDL Goal
Hypercholesterolemia Treatment
- Lifestyle Modifications (Diet, Exercise, Smoking Cessation)
- Statins
- Niacin
- Ezetimibe
- Fibrates
- Bile Acid Resins
- PCSK9 Inhibitors
- Omega 3 Fatty Acids
- Pooled Cohort Test
Cholesterol Lab Values
- LDL (Low Density Cholesterol)
- < 100 mg/dL
- HDL (High Density Cholesterol)
- > 40 mg/dL Males
- > 50 mg/dL Females
- Total Cholesterol
- < 200 mg/dL
Statins
- Rhabdomyolysis
- Hepatotoxicity
- HMG-CoA reductase inhibitors
- Decrease LDL
- Decrease Triglycerides
- Increase HDL
Atorvastatin (Lipitor)
- -statin Suffix
- HMG-CoA Reductase Inhibitors
- High Cholesterol
- Hepatotoxicity
- Rash
- Rhabdomyolysis
- Myopathy
- Monitor Liver Enzymes
- Administer at Bedtime
- Avoid Grapefruit
Fibrates
- Hyperlipidemia
- Upregulate LPL
- Decreases Triglycerides
- Slight Increase in HDL
- Slight Decrease in LDL
- Hepatotoxicity
- Cholesterol Gallstones
Ezetimibe
- Hyperlipidemia
- Cholesterol Absorption Blocker
- Decreases LDL
- Diarrhea
- Increased LFT Values
Bile Acid Resins
- Hyperlipidemia
- Bile Acid Reabsorption Prevented
- Slight Increase HDL/Triglycerides
- Decrease LDL
- Colestipol (Colestid)
- Cholestyramine
- Colesevelam
- Cholesterol Gallstones
- Decreased Absorption of Fat-soluble Vitamins
- Patients Hate It