HYPERLIPIDEMIA - Sapraa课件.ppt

HYPERLIPIDEMIA DR L RABANYE DEFINITION Major risk factor for atherosclerosis as a result of elevated levels of serum cholesterol Major component of Serum Cholesterol - LDL-C ( Low density level lipoprotein) - HDL-C (High density level lipoprotein) - TG ( Triglycyrides) Objective of Treatment Guidelines Identify patients at cardiovascular risk In-line with advances in diagnosis Incorporating newly identified/quantified risk factors Metabolic syndrome Diabetes Treatment guidelines based on evidence pool available at the time of publication Can be expected to change with the emergence of new evidence As evidence accumulates that greater LDL-C reductions are associated with greater reductions in CVD risk, guidelines are updated to reflect lowered LDL-C goals Developmental Process of Atherosclerosis Burden of Diseases (CV) The three leading causes of disease in 2030 HIV/ AIDS Unipolar depressive disease Ischaemic heart Disease Multiple Risk Factors Cause Cumulative Increase in Risk for CVD RISK FACTORS Obesity Smoking Diabetes Mellitus Lack of physical Exercise Hypertension Genetics Types Of Lipid Lowering Drugs Statins Fibrates Niacin Resins Selective cholesterol inhibitor Primary Prevention:Are We Identifying the Right Patients? Economic Burden of Cardiovascular Disease in the US Estimated for 2005 Effect of Long-Term Modest Reductions in CV Risk Factors Heart of Soweto Study Cross-Sectional Study at Chris Hani Baragwanath Objective: Describe recent ↑ in ACS among urban black South Africans Epidemiological transition due to urbanization adoption of Western lifestyle and diet vs. traditional (cardio-protective) African lifestyle 1950’s: average of 3 patients/annum identified with AMI 1975-80: Total of 50 cases – average of 8 patients/annum 2004: 64 patients with ACS in one year alone Annual incidence of ACS (based on population size) 1975-80: 0.5 – 1 per 100 000 2004: 7 per 100 000 Rule ou