Major CHD Risk Factors

Cigarette smoking

Htn

HDL-C <40 (L)

FHx (1st degree) of premature CHD (males <55 or females <65)

Age (>45M or >55F)

Life Habit Risk Factors

Obesity (esp central)

Insulin Resistence (independent of TII DM; this has impaired fasting glucose 

Sedentary Lifestyle

Atherogenic diet

PSF

Performing CHD Risk Assessment

If patient has 0 or 1 major risk factors: 10 year risk is less than 10% and they do not need a 10 year MI assessment.  Otherwise, perform Framingham Point Scores/Est 10 year risk:

Age, total cholesterol at their age, smoking status, HDL and systolic BP.  Can use cholesterol app on your phone

CHD Risk Equivalents

(Same risk for MI as someone who's already been dxn with CHD)

• Atherosclerotic dz
• PAD
• AAA
• Symptomatic carotid artery disease
• DM
• Risk factors contributing to a 10 year risk >20%

LDL-C Goals based on CAD risk

For individuals with 0 or 1 risk factor, the LDL-C goal is <160 mg/dL.

For individuals with 2 risk factors and a 10-year risk of 0%-20%, the LDL-C goal is <130 mg/dL.

For individuals with established CAD or a CAD risk equivalent, the LDL-C

goal is <100 mg/dL.

Causes of Secondary Dyslipidemia and Tests to Order to R/O

• Hyperglycemia/DM
• Fasting gluc
• Hypothyroidism
• TSH/FT4
• CRF/Nephrotic Syndrome
• BUN, Creatinine
• Obstructive liver disease
• LFTs
• Drugs
• EtOH, diuretics, B-blockers, progestins, estrogens, anabolic steroids, corticosteroids, cyclosporin, retinoids, interferon