Dyslipidemia
Overview
Dyslipidemias are disorders of the lipid system, which results in patients having an abnormal amount of lipids in their blood. They are classified as primary and secondary dyslipidemias.
Primary dyslipidemias are often caused by genetic disorders. The most common primary lipid disorders are:
- Chylomicronemia (hereditary or acquired): ↑↑↑↑ triglycerides (>1000 mg/dL). This is associated with an increased risk of acute pancreatitis.
- Familial hypercholesterolemia
- Homozygous (1/160,000-1/1,000,000 individuals): ↑↑↑↑↑ LDL-C
- Heterozygous (1/200-500 individuals): ↑↑↑↑ LDL-C
- Mixed hyperlipidemia
- Familial mixed (1/300 individuals): ↑ LDL-C , ↑↑ triglycerides, ↓↓ HDL-C
- Familial dysbeta lipoproteinemia (disease of lipoprotein deposits) (1:10,000 individuals): ↑ LDL-C, ↑↑ triglycerides, ↓ HDL cholesterol
- Familial hypertriglyceridemia (1/2,000 persons): ↑↑ triglycerides
- Familial decrease in HDL cholesterol: ↓↓ HDL-C
Secondary dyslipidemias, such as disorders of the lipid system caused by other diseases or drugs, must first be excluded for patients with abnormal values in their lipid profile. The most common causes of secondary dyslipidemias are:
- Diabetes mellitus
- Hypothyroidism
- Cholestasis
- Chronic kidney disease – Nephrotic syndrome
- Obesity
- Excessive alcohol consumption
- Medications
Diagnosis
To diagnose dyslipidemias, you will undergo a routine blood test. Depending on the findings, your medical team may recommend further testing.
Everyone should routinely test their lipid profiles, but some groups of people are at higher risk of developing dyslipidemias. These include:
- Men and women over 40 years of age
- Post-menopausal women
- People with clinical findings indicative of dyslipidemia
- Relatives of people with inherited lipid disorders
- People with a family history of early coronary heart disease
- Overweight and obese people with a body mass index (BMI) > 27 kg/m2
- Adults who experience sexual dysfunction
- Adults who smoke
- Children with a hereditary history of hyperlipidemia, cardiovascular disease or other risk factors
- Patients with arterial hypertension
- Patients with atherosclerotic disease, regardless of their age
- Patients with chronic inflammatory diseases, such as lupus erythematosus, rheumatoid arthritis, psoriasis or acquired immunodeficiency syndrome
- Patients with diabetes mellitus, regardless of their age
- Patients with chronic kidney disease
Treatment
The main goal when treating dyslipidemia is to reduce the “bad cholesterin” LDL-C from the blood. The treatment plan, including the type of medication your medical team will recommend and its dosage, depends on how much your lipid levels need to change and on any other conditions you may already have. Treatment for dyslipidemia is lifelong, and it is crucial that patients are disciplined with their treatment.
The cornerstone of dyslipidemia treatment are statins (atorvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin and fluvastatin). Other hypolipidemic medications include ezetimibe, fibrates (phenofibrate, gemfibrozil, bancafibrate) and omega-3 fatty acids. Recently, PCSK9 protein inhibitors have been used to treat dyslipidemia. Administration of these monoclonal antibodies is associated with an additional 50-60% reduction in LDL-C, in patients who are already receiving statin treatment with or without ezetimibe, and who have a very good safety profile.
Why GMI
Dyslipidemia is a major risk factor for the development of cardiovascular disease (acute myocardial infarction, stroke), while early diagnosis and appropriate treatment significantly reduce cardiovascular morbidity and mortality.
The GMI Lipid Center specializes in diagnosing and treating dyslipidemias. Patients with any type of dyslipidemia (from hypercholesterolemia to the most complex, genetic forms of dyslipidemia) can be referred to our center for treatment that follows the latest international, and European guidelines.
At the GMI, we see our patients holistically. At our Lipid Center, we also treat patients with common comorbid diseases such with arterial hypertension, diabetes mellitus, obesity, hyperuricemia, and other metabolic disorders. We offer both the best possible treatment and regular monitoring to patients with these disorders.
