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  • Lipids

    Cardiovascular disease especially coronary artery disease (CAD) is a very important health problem in Singapore today, and second only to cancer as a leading cause of mortality.  Dyslipidaemia is one of the most important modifiable risk factors for CAD.

    Classification of dyslipidaemia Increased concentration
    Lipoprotein Serum lipid
    Hypercholesterolemia LDL TC & LDL cholesterol
    Mixed (Combined) dyslipidaemia LDL & VLDL TC, LDL cholesterol & TG (1.7-4.5mmol/L or 150-399mg/dL)
    Hypertriglyceridemia VLDL TG (1.7-4.5 mmol/L or 150-399 mg/dL)
    Severe hypertriglyceridaemia Chylomicrons TG =/>4.5 mmol/L or 400 mg/dL)

    Principle in the prevention of CAD is that the intensity of risk reduction therapy should be adjusted to a person’s risk of developing future coronary events.

    Risk group category LDL cholesterol target level
    Very high risk group < 2.1 mmol/L (80 mg/dL)
    High risk group < 2.6 mmol/L (100 mg/dL)
    Intermediate risk group < 3.4 mmol/L (130 mg/dL)
    Low risk group < 4.1 mmol/L (160 mg/dL)

    A diet rich in wholegrain foods, vegetables, fruit, legumes, nuts, fish and unsaturated oils and low in saturated and trans fat, refined grains should be encouraged.

    Individuals with very high levels of TG, eg >4.5mmol/L (400mg/dL) have increased risk of acute pancreatitis and should be treated to reduce the risk of pancreatitis.

    Our chronic care programme for patients with dyslipidaemia may include the following

    Essential Care Component Recommended Frequency
    1 Lipid Profile Annually
    2 Smoking Assessment Annually
    3 Liver Function (Transaminases) At baseline, 8 weeks & thereafter annually
    4 Serum creatinine kinase At baseline, 8 weeks & thereafter annually

     

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