Cardiovascular System >
Dyslipidaemia
“Abnormal blood levels of one or more lipids or lipoproteins”
- Most common forms
- ↑ LDL
- ↓ HDL
- ↑ Triglycerides
- ↑ Cholesterol
Risk Factors
- Primary dyslipidaemia:
- Gene mutations eg LDLRAP1 mutation
- Secondary dyslipidaemia:
- Obesity
- T2DM
- Alcoholism
Aetiology
- Primary dyslipidaemia:
- Inherited
- Secondary dyslipidaemia:
- Acquired
Pathophysiology
- Primary dyslipidaemia:
- LDLRAP1 mutation:
- ↓ the efficiency of endocytosis of receptor-bound LDL particles
- ↓ Clearance of LDL from plasma
- ↑ Macrophage consumption of excess LDL cholesterol
- ↑ Atherosclerosis risk
- LDLRAP1 mutation:
- Secondary dyslipidaemia:
- Obesity & T2DM:
- Elevated FFA levels
- ↑ Hepatic VLDL-TG secretion
- Alcoholism:
- ↑ Hepatic VLDL secretion
- Obesity & T2DM:
Clinical Presentation
- High LDL:
- Tendinous xanthomas at the Achilles
- Knee tendons and elbows
- Xanthelasma
- Arcus corneae
- High TG:
- Xanthomas at knees, feet, elbows, and hands
Investigations
- Bloods:
- Serum lipid profile- including total cholesterol, TG, HDL, LDL, VLDL
- Imaging: n/a
- Special:
- Screening tests eg if FHx of severe hyperlipidaemia
Management
- Conservative:
- Lifestyle Management – exercise & dietary changes
- Medical:
- 1st line= Statin eg Lovastatin, Pravastatin.
- If statins fail, niacin/fibrates used (main aim of management: prevent atherosclerotic CVD)
- Surgical: n/a
Complications
- Atherosclerosis
- Myocardial Infarction
- Coronary artery disease
- Acute coronary syndrome
- Stroke