Lect 18 CVD Part 2

J exptl med 2006203813 816 3 hyperlipidemia elevation

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Unformatted text preview: lesions. J Exptl Med 2006;203:813-816. 3 Hyperlipidemia Elevation Elevation of plasma lipids and lipoproteins Cholesterol (Chol) Chol esters (CE) Triglycerides (TG) Cholesterol (Chol), Chol esters (CE), Triglycerides (TG), apolipoproteins apolipoproteins Lipid panel measures: total chol, HDL chol, & TG directly; values values for LDL chol are calculated Friedwald equation: LDL Chol = Tot chol - (HDL + 0.2 * TG) Diet - Gene interactions genetic variations affect plasma lipoprotein concentrations & therapeutic therapeutic response (apoB, (apoB, LDL receptor, apoE, apoA, Lp(a), etc.) 4 Lipoprotein Metabolism Cascade Metabolism Cascade 5 Lipoprotein Metabolism Cascade 6 Table 13-7, p. 301 7 Low Density Lipoprotein Density Lipoprotein 8 9 10 National National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III Classification of Cholesterol Levels Parameter Level (mg/dl) Classification LDL Cholesterol Cholesterol <100 Optimal 130-159 Borderline High 160-189 High >190 Very High High <200 Desirable 200-239 Borderline High High >240 High <40 Low >60 High Total Cholesterol HDL Cholesterol Cholesterol For conversion factors (mg/dl vs mmol/L) see JADA 2005 article KNOW THESE 11 Table 13-8, p. 301 12 Table 13-10a, p. 305 13 NCEP ATP III Treatment Goals Primary target is reduction of LDL cholesterol level goal is adjusted based on risk factors present Secondary target is diagnosis & reduction of underlying causes of the metabolic syndrome (diagnosis based on 3 of the following factors) abdominal obesity M >102 cm F>88 cm TG >150 mg/dl HDL chol M <40 mg/dl Insulin resistance Fasting BG >110 mg/dl HTN > 130/85 mm Hg F <50 mg/dl Treatment goals are achieved mainly with medical nutrition management (diet and lifestyle/behavioral changes) and then with drug therapy as needed. 14...
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This document was uploaded on 02/25/2013.

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