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In the Clinic®
D
yslipidemia is an important risk factor
for coronary artery disease and stroke. Diagnosis
Long-term, prospective epidemiologic
studies have consistently shown that persons
with healthier lifestyles and fewer risk factors for Treatment
coronary heart disease, and particularly those
with favorable lipid profiles, have reduced inci-
dence of coronary heart disease. Prevention Practice Improvement
and sensible management of dyslipidemia can
markedly alter cardiovascular morbidity and
mortality.
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lines propose use of the Pooled guidelines from the ACC/AHA 821-7. [PMID:
20458092]
Cohort Equations, a risk calcula- indicate that statins are the pre- 48. Sabaté J, Fraser GE,
Burke K, Knutsen SF,
tor based on several large clinical ferred drugs to lower lipids (7). Bennett H, Lindsted KD.
trials (7). Many large-scale, high-quality Effects of walnuts on
serum lipid levels and
clinical trials show that statins not blood pressure in normal
The third step is for the clinician only decrease LDL-C levels but men. N Engl J Med.
1993;328:603-7. [PMID:
and patient to share in the deci- also decrease cardiovascular 8357360]
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Ezetimibe 10 mg once per day Reduces LDL Well-tolerated, but Can use with statins for
Selectively inhibits cholesterol level by contraindicated in further LDL
intestinal absorption 18%, triglyceride patients with liver cholesterol and
of cholesterol and level by 8%, and disease or elevated triglyceride level
related phytosterols. apoB by 16%. liver enzyme levels. reduction and to
increase HDL
cholesterol level. Do
not combine with
resins, fibrates, or
cyclosporine.
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apoB = apolipoprotein B; CVD = cardiovascular disease; HDL = high-density lipoprotein; HMG-CoA = 3-hydroxy-3-methylglutaryl
coenzyme A; LDL = low-density lipoprotein; OTC = over-the-counter; PCSK9 = proprotein convertase subtilisin/kexin type 9; SQ =
subcutaneous; TC = total cholesterol; ULN = upper limit of normal; VLDL = very low-density lipoprotein.
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IntheClinic
In the Clinic Practice Guidelines
www.aace.com/files/lipid-guidelines.pdf
Tool Kit
Guidelines for prevention of cardiovascular disease by the
American Association of Clinical Endocrinologists and
the American College of Endocrinology.
www.healthquality.va.gov/guidelines/CD/lipids/
Guidelines from the U.S. Department of Veterans Affairs.
www.escardio.org/Guidelines/Clinical-Practice
Dyslipidemia -Guidelines/Dyslipidaemias-Management-of
Guidelines from the European Society of Cardiology.
Patient Information
www.lipid.org/practicetools/tools/tearsheets
Information and tear sheets on dyslipidemia and other
lipid disorders from the National Lipid Association.
http://pcna.net/clinical-tools/education-for-your
-patients/cholesterol
Information available in both English and Spanish from
the Preventive Cardiovascular Nurses Association.
https://medlineplus.gov/cholesterol.html
Information about cholesterol management from
Medline.
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Patient Information
This test may require you to not eat for a few dyslipidemia.
hours.
Questions for My Doctor
How Is It Treated? • Do I need to be screened for dyslipidemia?
Your doctor will work with you to create a plan for • What is the healthiest diet for me to eat?
your treatment. One part of your treatment will • Are there foods that I should not eat?
include making healthy changes, such as: • What is the best form of exercise for me?
• Eating a heart-healthy diet • What is the best medicine for me?
• Getting regular exercise • Does the medicine have side effects?
• Quitting smoking • Will this medicine interact with my other
• Losing weight if needed medicines?