Introduction
Hyperlipidemia can be defined as elevation of serum total cholesterol (TC) and/or triglyceride (TG) or reduced high-density lipoprotein (HDL) cholesterol that predisposes to the development of atherosclerosis.
Hyperlipidaemia is a major risk factor for ischemia heart disease
Clinical features
- Patients present with ischaemic heart disease or the underlying cause hyperlipideaemia
- Signs include xanthomata, xanthelasmata, and corneal arcus
Differential diagnoses
- Primary hyperlipidaemia
- Secondary hyperlipidaemia: diabetes mellitus,
- Nephrotic syndrome
Complications
- Ischaemic heart disease
- Peripheral vascular disease
- Stroke,
- Hypertension
Investigations
- Lipid profile
- Urea, Electrolytes and Creatinine
- Fasting blood glucose
- Urine proteins
- Serum proteins (total and differential)
Treatment objectives
- Lower lipid levels
- Prevent or treat complications
- Treat underlying causes
Non-drug treatment
- Stop smoking
- Reduce weight
- Exercise moderately and regularly
- Water soluble fibre: oat, bran
Drug treatment
- Atovastatin
Notable adverse drug reactions, caution and contraindications
- Caution in patients with history of liver disease, high alcohol intake
- Hypothyroidism should be adequately managed before starting treatment with a statin
- Liver function tests mandatory before and within 1 months of starting treatment; thereafter at intervals of 6 months for 1 year
- Statins may cause reversible myositis, headache, diarrhoea, nausea, vomiting, constipation, flatulence, abdominal pain;
insomnia
Prevention
- Dietary manipulation
- Early identification of individuals at risk.