How does Hyperlipidemia affect the heart? Write one paragraph (In your own words)
Answers
Your body needs cholesterol to build healthy cells, but high levels of cholesterol can increase your risk of heart disease. With high cholesterol, you can develop fatty deposits in your blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries
Answer:
Elevated levels of blood lipids are well documented risk factors for cardiovascular disease. Current classification schemes and treatment levels for hyperlipidemia are based on the National Cholesterol Education Panel’s (NCEP) Adult Treatment Program-3 (ATP-III) guidelines. Statins are the preferred class of drugs to lower elevated low density lipoprotein cholesterol (LDL-C). There are other classes to augment or substitute for statins, such as ezetimibe, fibrates, niacin and dietary supplements. Extensive research over the last decade has raised the question whether or not ATP-III guidelines are sufficiently aggressive. New guidelines from ATP-IV are expected to be released in the near future, but in the meantime physicians are faced with uncertainty about how low to target LDL-C, whether to pharmacologically treat high density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels and how best to achieve target goals.
Keywords: Hypercholesterolemia, Hypertriglyceridemia, Dyslipidemia, Cardiometabolic Risk, CVD Risk Factors
Introduction
Modern primary care practitioners spend considerable time and effort on preventative medicine. Diagnosing and managing hyperlipidemia as a way to prevent cardiovascular disease (CVD) is a common activity for primary care physicians. According to Centers for Disease Control data from a survey of 1,492 physicians who provide ambulatory care in non-government settings, hyperlipidemia is second only to hypertension in the list of the 10 most common chronic conditions that were seen (1) The fact that hyperlipidemia is a strong risk factor for CVD is well established. Hyperlipidemia refers to elevated cholesterol, elevated TG or both. The problem can be due solely to hereditary factors, but more commonly it is an acquired condition. Physicians need to know the major categories of dyslipidemia and to have a well reasoned action plan for dealing with each one, including knowing when to refer a case to a lipidology specialist. It is the purpose of this paper to review the categories of hyperlipidemia, the current treatment recommendations and the current controversies and unresolved questions. Some of the recent evidence based data (~2000 to current year) and studies regarding hyperlipidemia will be discussed.
Definitions of hyperlipidemia
For most primary care providers, hyperlipidemia is defined as elevations of fasting total cholesterol concentration which may or may not be associated with elevated TG concentration. However, lipids are not soluble in plasma, but are instead transported in particles known as lipoproteins. Therefore, classifications of hyperlipidemia are also based on abnormalities of lipoproteins. See Box 1.
Box 1. Classes of Apolipoproteins
Chylomicrons – Triglyceride rich carrier of dietary fats
Very Low Density Lipoprotein (VLDL) – Triglyceride rich carrier of hepatic synthesized triglycerides (TG)
Intermediate and Low Density Lipoprotein (IDL & LDL) – Cholesterol rich remnant particles derived from lipolysis of triglycerides in VLDL
High Density Lipoprotein (HDL) – Cholesterol rich particle that transports cholesterol to liver for disposal or recycling