Risk Factors for Statin-Induced Myopathy

High statin doses People whom are frail or have a small frame Elderly Perioperative periods Untreated hypothyroidism Diabetes Renal Diseases Liver Diseases Medications:  Nicotinic Acid, Fibrates (especially gemfibrozil), CYP450 3A4 Inhibitors (for simvastatin, lovastatin, and atorvastatin)

Lifestyle Recommendations for Patients with Hyperlipidemia

Saturated fat should account for less than 7% of total calories Total fat should account for less than 25-35% of total calories Fiber:  20-30 grams daily Consume less than 200 mg of dietary cholesterol daily

Lipid Management Goals

Non-LDL Cholesterol Triglycerides < 150 mg/dL Total Cholesterol < 200 mg/dL HDL > 40 mg/dL (males) HDL > 50 mg/dL (females) Non HDL Cholesterol:  LDL goal + 30 mg/dL LDL Cholesterol LDL < 70 mg/dL:  Preexisting coronary heart disease (CHD) at high risk LDL < 100 mg/dL:   CHD (myocardial infarction, unstable or chronic stable … Continue reading

Secondary Causes of Dyslipidemia

The following can increase Low Density Lipid (LDL) cholesterol levels: Hypothyroidism Obstructive Liver Disease Nephrotic Syndrome Medications:  Progestin, Corticosteroids, Anabolic Steroids, Cyclosporine The following can increase Triglyceride (TG) levels: Diabetes Hypothyroidism Nephrotic Syndrome Chronic Renal Failure Obesity Medications:  Estrogen, Thiazide Diuretics, Beta Blockers, Corticosteroids, Atypical Antipsychotics The following can decrease High Density Lipid (HDL) cholesterol … Continue reading

Useful Websites Regarding Lipid Management

http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm National Cholesterol Education program provides national guidelines for nonpharmacologic and pharmacologic recommendations for lipid management. http://www.nhlbi.nih.gov/guidelines/cholesterol/statins.htm Clinical advisory from the American College of Cardiology, AHA and the National Heart, Lung and Blood Institute (NHLBI) on the prevention and management of statin-adverse events http://hp2010.nhlbihin.net/cholmonth/ NHLBI designed website with supportive patient education materials http://www.heart.org/HEARTORG/Conditions/Cholesterol/Cholesterol_UCM_001089_SubHomePage.jsp AHA website … Continue reading