Harrison's Practice: Hyperlipidemia

Hyperlipidemia

Definition

Hyperlipidemia is characterized by elevated levels of lipids (cholesterol, triglycerides, lipoproteins) in the blood.
Lipoproteins
- Complexes of lipids and proteins that are essential for the transport of cholesterol, triglycerides, and fat-soluble vitamins
- Divided into 5 major classes, based on their relative densities (See Table 350-1.)
  - Chylomicrons
  - Very low–density lipoproteins (VLDL)
  - Intermediate-density lipoproteins (IDL)
  - Low-density lipoproteins (LDL)
  - High-density lipoproteins (HDL)
Apolipoproteins (See Table 350-2.)
- Required for assembly and structure of lipoproteins
- Activate enzymes important in lipoprotein metabolism and mediate binding of lipoproteins to cell-surface receptors
- Major apolipoproteins include apoA, apoB, apoC, and apoE.
Lipid disorders
- Group of disorders characterized by an excess of cholesterol, triglycerides, and/or lipoproteins present in the blood
- Disorders may be primary (genetic) or secondary (due to disease, diet, lifestyle, or drugs).
- Primary disorders:
  - Isolated hypercholesterolemia
    - Familial hypercholesterolemia (FH)
    - Familial defective apoB-100 (FDB)
    - Polygenic hypercholesterolemia
  - Isolated hypertriglyceridemia
    - Familial hypertriglyceridemia (FHTG)
    - Lipoprotein lipase (LPL) deficiency
    - Familial apoC-II deficiency
  - Hypercholesterolemia and hypertriglyceridemia
    - Familial combined hyperlipidemia (FCHL)
    - Familial dysbetalipoproteinemia (FDBL)
Lipid-lowering therapy
- Significantly reduces the development of atherosclerotic vascular disease
- LDL cholesterol (LDL-C) is the primary target of therapy.
- The National Cholesterol Education Program (NCEP) provides guidelines for risk assessment and treatment.
  - Adult Treatment Panel III (ATP-III) recommendations were last published in 2001.
  - Some recommendations were updated in July 2004.

Hyperlipidemia has been found in Harrison's Practice

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