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High Cholesterol in Adults

Key Recommendations:

  • Determine lipoprotein levels–obtain complete lipoprotein profile after 9- to 12-hour fast
  • Identify presence of clinical atherosclerotic disease that confers high risk for coronary heart disease (CHD) events (CHD risk equivalent):
    • Clinical CHD
    • Symptomatic carotid artery disease
    • Peripheral arterial disease
    • Abdominal aortic aneurysm
  • Determine presence of major risk factors (other than LDL):
    • Diabetes is regarded as a CHD risk equivalent
    • Cigarette smoking
    • Hypertension (BP >140/90 mmHg or on antihypertensive medication)
    • Low HDL cholesterol (<40 mg/dL)*
    • Family history of premature CHD (CHD in male first degree relative <55 years
    • CHD in female first degree relative <65 years)
    • Age (men >45 years; women >55 years)
  • Determine risk category:
    • Establish LDL goal of therapy
    • Determine need for therapeutic lifestyle changes (TLC)
    • Determine level for drug consideration

MQIC clinical practice guidelines/recommendations:
http://mqic.org/pdf/mqic_screening_and_management_of_hypercholesterolemia_cpg.pdf

References:
http://www.nhlbi.nih.gov/guidelines/cholesterol/

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