NR 511 Week 7 CPG Presentation – Cholesterol – Hyperlipidemia:Chamberlain College Of Nursing
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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)
RECOMMEND
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