Chamberlain College of NursingNR 511NR511 wk 7 CPG PPT (2).

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CHOLESTEROLHYPERLIPIDEMIA CLINICAL PRACTICE GUIDELINE ASSIGNMENT HELEN GAMADA NR511: DIFFERENTIAL DIAGNOSIS DR. MARGARET SMITH AUGUST 2019 INCIDENCE AND PREVALENCE IN U.S. In 2015-2016- > 12... % of adults had total cholesterol >240 mg/dL 18% had HDL level < 40 mg/dL 95 million U.S. adults age > 20 had total cholesterol level > 200 mg/dL Nearly 1 in 3 Americans have high cholesterol 29 million total cholesterol levels > 240 mg/dL 7% adolescents age 6-19 had high total cholesterol ("High Cholesterol Facts, " 2019) PATHOPHYSIOLOGY Cholesterol types Low-Density Lipoprotein (LDL) Very Low-Density Lipoprotein High-Density Lipoprotein (HDL) Is an essential lipophilic molecule for human life has many roles for the normal function of cells Is an essential component of the cell membrane Is a precursor molecule in vitamin D synthesis, steroid hormones, sex hormones Is a constituent of bile salt-used in the digestion of fat-soluble vitamins A,D, E, and K ("Hypercholesterolemia (high blood cholesterol) information | myVMC," n.d.). PATHOPHYSIOLOGY CONT… High cholesterol -major risk factor for the formation of atherosclerotic plaques Endothelial damage leads to dysfunction of endothelial cells Atherosclerotic plaque begins to develop in damaged inner lining More cholesterol and other materials accumulate Plaque continues to grow and block blood flow plaque ruptures a blood clot forms blockage ("Hypercholesterolemia (high blood cholesterol) information | myVMC," n.d.). ("sruthi b, Author at - Page 2 of 3," n.d.) TYPICAL CLINICAL PRESENTATION No specific symptoms of high cholesterol Very high cholesterol may show xanthomas and corneal arcus Undiagnosed and untreated high cholesterol leads to heart attack and stroke ("High Blood Cholesterol," n.d.) CLINICAL PRACTICE GUIDELINE (CPG) Author- Developed by a task force of the American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) Organization- American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) Groups -Writing committee for the AACE/ACE clinical practice guidelines for the management of dyslipidemia and prevention of cardiovascular disease Original- 1995 Subsequent revisions-2017,2015,2010,2004,1995 (“America Association of Clinical Endocrinologists Protocol for Standardized Production of Clinical Practice Guidelines,” 2004) CPG APPLICATION IN PRIMARY CARE For the prevention of primary and secondary atherosclerotic disease Helps as a tool to reduce the risk and consequence of hyperlipidemia To treat LDL-C in some individuals to support the coronary artery calcium scores and inflammatory markers To give special consideration for : Diabetes Familial hypercholesterolemia Women Pediatrics with dyslipidemia (Jellinger et al., 2017) FIVE RELEVANT RECOMMENDATIONS 87 total recommendation 45 are grade A strong recommendation 18 are grade B moderate recommendation 15 are grade C weak recommendation 9 are grade D recommendation against (Jellinger et al., 2017) RECOMMENDATION #1 Identifying risk factors that enable personalized and optimal therapy for dyslipidemia -Grade A strong recommendation Major risk factors are: Advancing age Hypertension High Total serum cholesterol level Chronic kidney disease High non–HDL-C Cigarette smoking [Show More]

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