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Hypercholesterolemia

Cameron D. Blegen, MD and James E. Hougas, III, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Elevated cholesterol is a significant risk factor for atherosclerotic cardiovascular disease (ASCVD).

  • Lipoprotein subtypes:

    • Low-density lipoproteins (LDL): atherogenic; primary target ...

DIAGNOSIS

Screening recommendations: 
  • U.S. Preventive Services Task Force (USPSTF) (2)[A]: TC and HDL cholesterol (HDL-C) every 5 years

    • Men and women ≥40 years

    • No recommendation for or against screening ...

TREATMENT

ALERT

The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines no longer recommend treatment to an LDL goal. ACC/AHA and USPSTF guidelines recommend...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Exercise: sustained exercise for 30 minutes, 3 to 4 times per week: increases HDL, lowers TC, and helps control weight 

Patient Monitoring

  • Routine monitoring of LDL...

REFERENCES

1
Centers for Disease Control and Prevention. High cholesterol facts. https://www.cdc.gov/cholesterol/facts.htm. Accessed September 28, 2018. https://www.cdc.gov/cholesterol/facts.htm. Acces...

ADDITIONAL READING

Last AR, Ference JD, Menzel ER. Hyperlipidemia: drugs for cardiovascular risk reduction in adults. Am Fam Physician.  2017;95(2):78–87. [View Abstract on OvidMedline] 

SEE ALSO

D...

CODES

ICD10

E78.0 Pure hypercholesterolemia 

ICD9

272.0 Pure hypercholesterolemia 

SNOMED

  • 13644009 Hypercholesterolemia (disorder)

  • 398036000 Familial hypercholesterolemia (disorder)

  • 238076009 primary hyperch...

CLINICAL PEARLS

  • Hypercholesterolemia is a significant risk factor for ASCVD, but ASCVD is a multifactorial disease with many different risk factors.

  • Diet and exercise should be tried before pharmaceuti...

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