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Courses Phar 6122

 

ekgcircle3.gif (1164 bytes) Lecture Outlines: Diseases/Syndromes
Hyperlipidemia
 
Pathophysiology of the Atherosclerotic Process
Classification of Hyperlipidemia

General Approach to Treatment
NCEP Goals and Targets 

Risk Factors for ASCVD
Dietary Considerations

Drug Therapy
Special Considerations

Misc. Current Issues

Selected Studies
Example Exam Question
References
LFT Monitoring
CURRENT (updated) National Cholesterol Education Program GUIDELINES:
LDL Cholesterol Goals and Cutpoints for Therapeutic Lifestyle Changes (TLC) and Drug Therapy in Different Risk Categories (Link to ATP III Guidelines), Grundy White Paper Circulation 2004;110:227-239

2004 Treatment Guidelines Treatment Guidelines

Updated LDL Cholesterol Cutoffs for Lifestyle Interventions
and Drug Therapy in Different Risk Categories

Risk Category

LDL Cholesterol Goal

Initiate Therapeutic Lifestyle Changes

Cosider Drug Therapy
High Risk: CHD or CHD risk equivalents (10-year risk > 20%)
 <100 mg/dL (with an optional goal of <70mg/dL) ≥ 100 mg/dL

≥ 100 mg/dL (consider drug options if
LDL-C < 100 mg/dL)
Moderately high risk: two or more risk factors (10-year risk 10%-20%)
 < 130 mg/dL (with an optional goal of < 100 mg/dL) > 130 mg/dL
 ≥ 130 mg/dL (consider drug options if
LDL-C 100-129 mg/dL)
Moderate risk: two or more risk factors (10-year risk < 10%)
 < 130 mg/dL ≥ 130 mg/dL > 160 mg/dL
Low risk: ≤ 1 risk factor
< 160 mg/dL > 160 mg/dL
 > 190mg/dL (consider drug options if LDL-C 160-189 mg/dL)

Grundy, Circulation 2004; 110:227-239.

¢: Some authorities recommend use of LDL-lowering drugs in this category in an LDL cholesterol level of
<100 mg/dL cannot be achieved by therapeutic lifestyle changes.  Others prefer use of drugs that primarily modify triglycerides and HDL, eg. nicotinic acid or fibrate.  Clinical judgment also may call for deferring drug therapy in this subcategory.

»: Almost all people with 0-1 risk factor have a 10 year risk <10%; thus, 10 year risk assessment in people with 0-1 risk factor is not necessary.
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