Transcription for Clinical Practice Guideline (CPG)on Hyperlipidemia by Lakhvir Brar
Slide # 1:
Hello Dr. Williams and Class. My name is Lakhvir Brar. In this presentation, I am going to
discuss the clinical practice guidelines in the management of hyperlipidemia and the prevention
of cardiovascular complications as developed by the American College of Endocrinology and the
American Association of Clinical Endocrinologists.
Slide # 2: Disease and background
Hyperlipidaemia is a disorder, which is characterized by high levels of cholesterol, triglycerides
and fats in the body. Cholesterol is a waxy fat protein that aids in the proper functioning of cell
membrane, brain, the production of hormones, and storage of vitamins in the body. The excess
cholesterol results to a condition called the hypercholesterolemia, which is a common form of
hyperlipidemia. There are two types of cholesterols level in the blood, one is high low-density
lipoprotein cholesterol (LDL-C) and the other is reduced high-density lipoprotein cholesterol
(HDL-C). It is among the major risk factors for cardiovascular diseases including coronary
atherosclerosis, Cerebro-vascular accident (CVA) and heart attacks. The CPG was developed to
help in screening, assessment and treatment of patients with hyperlipidemia.
Slide # 3: Incidence and Prevalence
According to the CDC in 2015, there were almost 31 million American adults with cholesterol
above the normal ranges. In the United States, in 2016, approximately 53% of adults had
increased levels of low-density lipoprotein cholesterol that is LDL-C of more than 240 mg/dL
and there were 18% adults who had high-density lipoprotein cholesterol that is HDL-C levels
below 40 mg/dL . Men accounted for 28.5% and women 8.9%. The Caucasian women have
high prevalence rate 14.8 % and where Hispanic women is 9.0%.There were less than 35%
, people who seek treatment and are able to control the cholesterol levels.This has increased the
risks for cardiovascular diseases which is a leading cause of death The high prevalence of LDL-
C of ≥ 240 mg/dL and low HDL-C < 40 mg/dL of has increased the risks for cardiovascular
diseases which is a leading cause of death. In the incidence of heart disease related to bad
cholesterol, it is estimated that there are almost 790,000 events of heart disease per year.
Slide # 4: Pathophysiology
In the next part of the presentation, let me talk about the pathophysiology of the condition.
Hyperlipidemia results from abnormalities in metabolism of lipids or disorder in synthesis and
breakdown of lipoprotein in the body. Hyperlipidemia causes the increased oxidation resulting to
oxygen free radicals. This modifies low-density lipoprotein cholesterol that is LDL-C. Also,
insulin resistance leads to high level of plasma triglycerides and LDL-C and low concentration of
HDL-C. Primary hyperlipidemia occurs as a result of mutation in protein receptors due to
monogenic or polygenic gene defects. These genes defect either affects lipid metabolism causing
hypertriglyceridemia or lipoprotein lipase activity and the surface apoprotein CII31 causing
hyperlipidemia. In secondary hyperlipidemia, LDL-C are deposited in the arterial walls where
they are oxidized and modified through non-enzymatic glycation. This provokes an
inflammatory response leading a fibrous plaque on the arterial walls. These cholesterols
form deposit in the arterial wall which causes the narrowing of the arteries which is called
atherosclerosis. The narrowing of arteries results to the unstable blood flow because the heart is
unable to adequately pump blood through the constricted blood vessels.
Slide # 5: Typical clinical presentation
Most individuals with hyperlipidaemia are asymptomatic, until it has progressed to the point
where it has caused flow limiting atherosclerosis. Hyperlipidemia can be diagnosed by routine
Slide # 1:
Hello Dr. Williams and Class. My name is Lakhvir Brar. In this presentation, I am going to
discuss the clinical practice guidelines in the management of hyperlipidemia and the prevention
of cardiovascular complications as developed by the American College of Endocrinology and the
American Association of Clinical Endocrinologists.
Slide # 2: Disease and background
Hyperlipidaemia is a disorder, which is characterized by high levels of cholesterol, triglycerides
and fats in the body. Cholesterol is a waxy fat protein that aids in the proper functioning of cell
membrane, brain, the production of hormones, and storage of vitamins in the body. The excess
cholesterol results to a condition called the hypercholesterolemia, which is a common form of
hyperlipidemia. There are two types of cholesterols level in the blood, one is high low-density
lipoprotein cholesterol (LDL-C) and the other is reduced high-density lipoprotein cholesterol
(HDL-C). It is among the major risk factors for cardiovascular diseases including coronary
atherosclerosis, Cerebro-vascular accident (CVA) and heart attacks. The CPG was developed to
help in screening, assessment and treatment of patients with hyperlipidemia.
Slide # 3: Incidence and Prevalence
According to the CDC in 2015, there were almost 31 million American adults with cholesterol
above the normal ranges. In the United States, in 2016, approximately 53% of adults had
increased levels of low-density lipoprotein cholesterol that is LDL-C of more than 240 mg/dL
and there were 18% adults who had high-density lipoprotein cholesterol that is HDL-C levels
below 40 mg/dL . Men accounted for 28.5% and women 8.9%. The Caucasian women have
high prevalence rate 14.8 % and where Hispanic women is 9.0%.There were less than 35%
, people who seek treatment and are able to control the cholesterol levels.This has increased the
risks for cardiovascular diseases which is a leading cause of death The high prevalence of LDL-
C of ≥ 240 mg/dL and low HDL-C < 40 mg/dL of has increased the risks for cardiovascular
diseases which is a leading cause of death. In the incidence of heart disease related to bad
cholesterol, it is estimated that there are almost 790,000 events of heart disease per year.
Slide # 4: Pathophysiology
In the next part of the presentation, let me talk about the pathophysiology of the condition.
Hyperlipidemia results from abnormalities in metabolism of lipids or disorder in synthesis and
breakdown of lipoprotein in the body. Hyperlipidemia causes the increased oxidation resulting to
oxygen free radicals. This modifies low-density lipoprotein cholesterol that is LDL-C. Also,
insulin resistance leads to high level of plasma triglycerides and LDL-C and low concentration of
HDL-C. Primary hyperlipidemia occurs as a result of mutation in protein receptors due to
monogenic or polygenic gene defects. These genes defect either affects lipid metabolism causing
hypertriglyceridemia or lipoprotein lipase activity and the surface apoprotein CII31 causing
hyperlipidemia. In secondary hyperlipidemia, LDL-C are deposited in the arterial walls where
they are oxidized and modified through non-enzymatic glycation. This provokes an
inflammatory response leading a fibrous plaque on the arterial walls. These cholesterols
form deposit in the arterial wall which causes the narrowing of the arteries which is called
atherosclerosis. The narrowing of arteries results to the unstable blood flow because the heart is
unable to adequately pump blood through the constricted blood vessels.
Slide # 5: Typical clinical presentation
Most individuals with hyperlipidaemia are asymptomatic, until it has progressed to the point
where it has caused flow limiting atherosclerosis. Hyperlipidemia can be diagnosed by routine
