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• W91304106 abstract "Endothelial damage in the setting of risk factors sets the stage for the complex process of atherosclerosis. Plaque rupture is more common in hyperlipidemic patients. Vulnerable plaques have a large accumulation of core liquid, a high density of macrophages at the margins of its thinned fibrous plaque. Plaque rupture occurs more frequently in men with coronary artery disease (CAD) who have abnormal lipids.Lipids are transported on lipoproteins. Cholesterol-rich lipoproteins are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Triglyceride rich lipoproteins include very low-density lipoprotein (VLDL) and chylomicrons as well as remnant particles.Both total cholesterol and HDL cholesterol (HDLC) should be measured in all adults older than age 19 at least once every 5 years.Intervention focuses on LDL cholesterol (LDLC) calculated by measurement of fasting total cholesterol, triglycerides, and HDLC.Risk factors include age, menopausal status, hypertension, Type 2 diabetes mellitus, cigarette smoking, and family history of premature cardiovascular disease (before 65 years of age in female and 55 in male relatives); sedentary lifestyle and obesity are targets of intervention that should improve one or more risk factors.Secondary causes of hyperlipidemia should always be ruled out before treatment begins.Diet is important in not only reducing LDLC, but along with regular exercise in combating weight gain and insulin resistance, it can provide needed antioxidants in the form of fruits and vegetables.Primary prevention trials have shown the value of statin therapy in middle-aged subjects characterized by low HDL cholesterol or having a high-risk profile.Secondary prevention trials have shown that in those with greatly elevated cholesterol levels, lowering of LDLC with statin therapy results in enhanced survival, fewer cardiovascular events, and fewer revascularization procedures. In those with CAD and normal cholesterol values, statin therapy reduces the rate of fatal and nonfatal myocardial infarction as well as revascularization procedures.Successful drug therapy must consider the HMG CoA reductase inhibitors, niacin, bile acid sequestering resins such as cholestyramine or colestipol, and fibrates such as gemfibrozil or fenofibrate. Guidelines for their successful use alone or in combination are given." @default.
• W91304106 created "2016-06-24" @default.
• W91304106 creator A5053163891 @default.
• W91304106 date "2001-01-01" @default.
• W91304106 modified "2023-09-24" @default.
• W91304106 title "Approach to the Patient with Hyperlipidemia" @default.
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• W91304106 doi "https://doi.org/10.1007/978-1-4615-6601-4_14" @default.
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