Hypercholesterolemia secondary targets: Difference between revisions
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{{Hypercholesterolemia}} | {{Hypercholesterolemia}} | ||
'''Editor-In-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto: | '''Editor-In-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com] Phone:617-632-7753; '''Associate Editor(s)-In-Chief:''' [[Kashish Goel|Kashish Goel, M.D.]] | ||
__NOTOC__ | __NOTOC__ | ||
==The Metabolic Syndrome== | ==The Metabolic Syndrome== | ||
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|}<br> | |}<br> | ||
==Management== | |||
The management of the [[metabolic syndrome]] is multifold. It is considered as a secondary target for therapy after the LDL goal has been achieved. It mainly includes 3 main components: | The management of the [[metabolic syndrome]] is multifold. It is considered as a secondary target for therapy after the LDL goal has been achieved. It mainly includes 3 main components: | ||
=== | ===Reducing Weight=== | ||
Obesity | Obesity is a major underlying risk factors for [[CHD]]. After the LDL goal has been achieved, targeted interventions towards weight reduction should be designed for each individual. This will help in reducing the [[LDL]] and reduce other risk factors associated with the [[metabolic syndrome]]. | ||
=== | ===Increasing Physical activity=== | ||
Sedentary lifestyle and physical inactivity are major risk factors for [[CHD]]. Regular physical activity raises [[HDL]], reduces [[VLDL]] and may also lower [[LDL]] levels. It also helps in improving cardiovascular fitness and insulin resistance and should be a part of the regimen of each patients on LDL lowering therapy. | Sedentary lifestyle and physical inactivity are major risk factors for [[CHD]]. Regular physical activity raises [[HDL]], reduces [[VLDL]] and may also lower [[LDL]] levels. It also helps in improving cardiovascular fitness and [[insulin resistance]] and should be a part of the regimen of each patients on [[LDL]] lowering therapy. | ||
=== | ===Reducing other Components of Metabolic Syndrome=== | ||
In addition to the 2 main underlying risk factors (obesity and physical inactivity), it is important to modify the individual components of the [[metabolic syndrome]]. This would include better control of hypertension, use of aspirin for primary prevention to reduce the prothrombotic state), better control of diabetes and impaired glucose | In addition to the 2 main underlying risk factors (obesity and physical inactivity), it is important to modify the individual components of the [[metabolic syndrome]]. This would include better control of [[hypertension]], use of [[aspirin]] for primary prevention to reduce the [[prothrombotic state]]), better control of [[diabetes]] and impaired [[glucose tolerance]] and treatment of elevated [[triglycerides]] and low [[HDL]]. | ||
==References== | ==References== | ||
Latest revision as of 16:53, 1 November 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor(s)-In-Chief: Kashish Goel, M.D.
The Metabolic Syndrome
The metabolic syndrome is identified as a secondary target of therapy in the NCEP ATP III guidelines, beyond LDL cholesterol. The metabolic syndrome is a constellation of multiple risk factors which are lipid and non-lipid in origin. The basic metabolic abnormality associated with the metabolic syndrome is insulin resistance. Two main factors are responsible for the development of insulin resistance which include abdominal obesity and physical inactivity. The definition of the metabolic syndrome[1] includes:
- Clinical Identification of the Metabolic Syndrome
Risk Factor Defining level Abdominal Obesity:
Men
WomenWaist Circumference:
>102 cm (>40 in)
>88 cm (>35 in)Triglycerides ≥ 150 mg/dL HDL cholesterol
Men
Women
<40 mg/dL
<50 mg/dLBlood pressure ≥ 130/≥ 85 mmHg Fasting glucose ≥ 110 mg/dL
Management
The management of the metabolic syndrome is multifold. It is considered as a secondary target for therapy after the LDL goal has been achieved. It mainly includes 3 main components:
Reducing Weight
Obesity is a major underlying risk factors for CHD. After the LDL goal has been achieved, targeted interventions towards weight reduction should be designed for each individual. This will help in reducing the LDL and reduce other risk factors associated with the metabolic syndrome.
Increasing Physical activity
Sedentary lifestyle and physical inactivity are major risk factors for CHD. Regular physical activity raises HDL, reduces VLDL and may also lower LDL levels. It also helps in improving cardiovascular fitness and insulin resistance and should be a part of the regimen of each patients on LDL lowering therapy.
Reducing other Components of Metabolic Syndrome
In addition to the 2 main underlying risk factors (obesity and physical inactivity), it is important to modify the individual components of the metabolic syndrome. This would include better control of hypertension, use of aspirin for primary prevention to reduce the prothrombotic state), better control of diabetes and impaired glucose tolerance and treatment of elevated triglycerides and low HDL.
References
- ↑ National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2002). "Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report". Circulation. 106 (25): 3143–421. PMID 12485966.