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Hypercholesterolemia

Michelle Nelson, MD and Egle Klugiene, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Elevated cholesterol is considered a significant risk factor for atherosclerotic cardiovascular disease (ASCVD), although the relationship is not simple.

  • Lipoprotein subtypes:

    • Low-dens...

DIAGNOSIS

Screening recommendations: 
  • U.S. Preventive Services Task Force (USPSTF) (1)[A]: TC and HDL cholesterol (HDL-C) every 5 years

    • Men and women ≥40 years

    • No recommendation for or against screening ...

TREATMENT

ALERT

Multiple differing guidelines exist. Patient-centered decision. The 2018 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines return to targeting L...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Exercise: sustained exercise for 150 minutes per week: increases HDL, lowers TC, and helps control weight 

Patient Monitoring

  • Routine monitoring of lipid levels is ...

REFERENCES

1
U.S. Preventive Services Task Force. Final recommendation statement: statin use for the primary prevention of cardiovascular disease in adults: preventive medication. https://www.usprevent...

ADDITIONAL READING

Ravnskov U, de Lorgeril M, Diamond DM, et al. LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature. Expert Rev Clin Pharmacol.  2018;11...

CODES

ICD10

E78.0 Pure hypercholesterolemia 

ICD9

272.0 Pure hypercholesterolemia 

SNOMED

  • 13644009 Hypercholesterolemia (disorder)

  • 398036000 Familial hypercholesterolemia (disorder)

  • 238076009 primary hyperch...

CLINICAL PEARLS

Diet, particularly the Mediterranean diet, and exercise should be tried before pharmaceutical interventions. 

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