BPS 334 Lecture Notes - Lecture 30: Combined Hyperlipidemia, High-Density Lipoprotein, Fluvastatin

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Primary hypercholesterolemia: high cholesterol (260-500 mg/dl) with normal triglycerides. Homozygous is very rare = 1000 mg/dl. Mutation in apob100 leads to decreased affinity to ldlr. Mixed hyperlipidemia: complex lipid profile with elevated total cholesterol, ldl, triglycerides; Often with obesity, hyperinsulinemia, glucose intolerance, mild hypertension. Statins may combine with fibrates and niacin. Treatment: decrease fat and cholesterol intake; niacin and fibrates. Based on genetic/metabolic studies, observational studies, randomized clinical trials. Framingham risk calculator: estimates 10 year risk of chd, for adults 20 years and older without heart disease or dm, doesn"t include family. Focus on % lowering in ldl-c: >50, 30%-50% Identified four patient groups likely to have benefits from statins. 10-year risk: estimates 10-year risk of 1st. Ascvd event and lifetime risk in patients 20-59 years: based on diverse populations. Treatment: lifestyle changes, only statins, subsequent addition of non- statin drugs to raise hdl-c and lower triglycerides. Heavily influenced by patient age (65 for man, 71 for woman)

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