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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The predominant cause of death among diabetic patients in populations with high cholesterol levels is coronary heart disease. This effect is related to diet and both insulin dependent and non-dependent diabetes are characterized by an increase in circulating very low density lipoprotein (VLDL). Insulin deficiency or resistance accelerates the release of VLDL from the liver. However, the susceptibility to vascular disease seen among diabetics may be a particular function of their raised levels of intermediate density lipoproteins (IDL) produced when VLDL is metabolised to low density lipoprotein. The concept of hyperinsulinaemia is not helpful in explaining the diabetic patient's disturbed metabolism and is a source of confusion. The major therapeutic task in non-insulin-dependent diabetes is often to reduce the patient's weight and thus to reduce insulin resistance. In patients with coronary heart disease, this should be fully investigated at least as promptly as in non-diabetic people. Lipid lowering drugs, and particularly the fibrates, are suitable for treating diabetic patients since they lower both cholesterol and triglycerides and raise HDL. There is much more controversy about the ideal choice of antihypertensive agents, particularly for patients with only moderate increases in blood pressure. Both thiazides and beta-blockers disturb the lipid profile most markedly in many patients with diabetes or primary hyperlipidaemia. Current evidence suggests that many patients with hypertension, but no other cardiovascular risk factors, derive no benefit from receiving antihypertensive therapy. As in the management of hypercholesterolaemia, the decision to introduce drug therapy should not be determined by the blood pressure reading alone, but should take account of the whole patient risk. The combination of even "mild" hypertension with diabetes or hyperlipidaemia demands greater therapeutic activity and then there is a case for the use of antihypertensive agents which do not adversely influence the lipid profile.
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PMID:Diabetes, hypertension and hyperlipidaemia. 849 53

The multifactorial nature of cataractogenesis has been further exposed in recent epidemiologic studies, most efficiently by four case-control studies. The factors found include various plasma constituents, steroids, alcohol, diabetes, hypertension, hyperlipidemia, and obesity. Further examination of dietary factors leaves confusion as to their role in the prevention of cataract.
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PMID:Recent studies of risk factors and protective factors for cataract. 1016 73

Hyperlipidemia is one of the major modifiable risk factors for coronary heart disease in men and women. There is substantial epidemiological data showing the relationship between elevations in total and low-density lipoprotein cholesterol, triglycerides and low high-density lipoprotein cholesterol, and coronary heart disease in women. Yet hyperlipidemia is undertreated in women. This may be due to limited data to support intervention for the primary prevention of coronary heart disease, confusion in national guidelines, and inadequate counseling on diet and exercise in clinical practice. Lipid levels should be evaluated in women with established coronary heart disease, cerebrovascular disease, peripheral vascular disease, and diabetes. These women should be targeted for aggressive lipid lowering with diet, exercise, and medication. Women with multiple risk factors and early family history of coronary heart disease should also be evaluated. Asymptomatic young women with elevated or borderline lipids should be counseled with regard to lifestyle and behavioral interventions such as diet and exercise. (c) 2000 by CHF, Inc.
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PMID:Lipid lowering strategies in women. 1183 11

Between 1994 and 2004, homogenous assays for HDL-C and LDL-C based on different determination principles were developed to replace complicated conventional precipitation methods. Nowadays, most laboratories employ homogenous assays. However, due to differences in principles and reactivity, measurements made by different assays do not necessarily match in some cases. HDL-C determinations may vary depending on duration and conditions of serum storage for the CDC-DCM and the homogenous assay methods, due to their different principles of determination. In patients with cholestasis, apoE-rich HDL, Lp-X and Lp-Y are occasionally observed. In these cases, the reactivity of homogenous assays for HDL-C varies markedly among the manufacturers. Furthermore, because the specific gravities of Lp-X and Lp-Y are comparable to that of LDL, these lipoproteins are grouped as LDL by ultracentrifugation, and this is a source of confusion in clinical settings. The American CDC assesses the accuracy of cholesterol assays by the BQ method, which measures the total of IDL, the narrowly-defined LDL, and Lp(a). However, of the various homogenous assays for LDL-C, reactivities to IDL and Lp (a) differ, and as a result, it is possible that type III hyperlipidemia characterized by increased IDL may be misdiagnosed.
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PMID:[Pitfalls in homogeneous assays for HDL-c and LDL-c in serum]. 1579 47

A 71-year-old African American woman presented with a past medical history significant for diabetes mellitus, coronary artery disease, hypertension and hyperlipidemia. She was being treated with atorvastatin and verapamil in addition to a few other medications. She complained of nausea, vomiting, myalgia, generalized weakness and dark urine. Initial evaluation revealed clinical icterus and mild mental confusion. Admission laboratory results showed features of multiple organ dysfunction. Over the course of four to five days the patient deteriorated to multiple organ failure resulting in death. Extensive work up for the etiology for multiple organ failure was noncontributory. We presume the cause for multiple organ failure could be the result of drug-drug interaction, atorvastatin and verapamil, as verapamil is known to increase the serum concentration of atorvastatin significantly.
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PMID:Atorvastatin induced multiple organ failure. 2066 69

Prevention has potential benefits, but the majority of people undergoing disease screening will receive no benefit and may actually be exposed to health risks. Public opinion is generally very favorable toward prevention. However, many recent guidelines recommend fewer preventive services in women than previously suggested. New recommendations are to wait until 50 for mammography screening, to screen only every other year, and to not teach self breast examinations. Papanicolaou tests for cervical cancer screening are recommended to be done less often (every 2-3 years) and to be started later than previously suggested (not before age 21). Screening for ovarian cancer is not recommended. Guidelines suggest avoiding hormone therapy for primary prevention of coronary heart disease, not giving aspirin to prevent myocardial infarctions in women, and not screening women without risk factors for hyperlipidemia. These recommendations have caused confusion and, because of being revealed during a national health reform debate, have even been perceived as "rationing care." Others see them as "rational care," because they encourage utilization of beneficial services while discouraging use of those that may lead to more harms than benefits. Development of prevention guidelines requires value judgments, so despite the use of evidence, these recommendations have not all achieved widespread support. Understanding the data behind the guidelines, health care providers can decide how to approach prevention in practice, taking into consideration individual patient risk factors and preferences.
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PMID:Rational care or rationing care? Updates and controversies in women's prevention. 2279 59

Prevention has potential benefits, but the majority of people undergoing disease screening will receive no benefit and may actually be exposed to health risks. Public opinion is generally very favorable toward prevention. However, many recent guidelines recommend fewer preventive services in women than previously suggested. New recommendations are to wait until 50 for mammography screening, to screen only every other year, and to not teach self breast examinations. Papanicolaou tests for cervical cancer screening are recommended to be done less often (every 2-3 years) and to be started later than previously suggested (not before age 21). Screening for ovarian cancer is not recommended. Guidelines suggest avoiding hormone therapy for primary prevention of coronary heart disease, not giving aspirin to prevent myocardial infarctions in women, and not screening women without risk factors for hyperlipidemia. These recommendations have caused confusion and, because of being revealed during a national health reform debate, have even been perceived as "rationing care." Others see them as "rational care," because they encourage utilization of beneficial services while discouraging use of those that may lead to more harms than benefits. Development of prevention guidelines requires value judgments, so despite the use of evidence, these recommendations have not all achieved widespread support. Understanding the data behind the guidelines, health care providers can decide how to approach prevention in practice, taking into consideration individual patient risk factors and preferences.
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PMID:Rational care or rationing care? Updates and controversies in women's prevention. 2132 70

Serum consists of water (93% of serum volume) and nonaqueous components, mainly lipids and proteins (7% of serum volume). Sodium is restricted to serum water. In states of hyperproteinemia or hyperlipidemia, there is an increased mass of the nonaqueous components of serum and a concomitant decrease in the proportion of serum composed of water. Thus, pseudohyponatremia results because the flame photometry method measures sodium concentration in whole plasma. A sodium-selective electrode gives the true, physiologically pertinent sodium concentration because it measures sodium activity in serum water. Whereas the serum sample is diluted in indirect potentiometry, the sample is not diluted in direct potentiometry. Because only direct reading gives an accurate concentration, we suspect that indirect potentiometry which many hospital laboratories are now using may mislead us to confusion in interpreting the serum sodium data. However, it seems that indirect potentiometry very rarely gives us discernibly low serum sodium levels in cases with hyperproteinemia and hyperlipidemia. As long as small margins of errors are kept in mind of clinicians when serum sodium is measured from the patients with hyperproteinemia or hyperlipidemia, the present methods for measuring sodium concentration in serum by indirect sodium-selective electrode potentiometry could be maintained in the clinical practice.
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PMID:Pseudohyponatremia: does it matter in current clinical practice? 2445 91

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality for women in the United States and worldwide. There has been no American College of Cardiology (ACC)/American Heart Association guideline update specifically for the prevention of CVD in women since 2011. Since then, the body of sex-specific data has grown, in addition to updated hypertension, cholesterol, diabetes, atrial fibrillation, and primary prevention guidelines. The ACC CVD in Women Committee undertook a review of the recent guidelines and major studies to summarize recommendations pertinent to women. In this update, the authors address special topics, particularly the risk factors and treatments that have led to some controversies and confusion. Specifically, sex-related risk factors, hypertension, diabetes, hyperlipidemia, anticoagulation for atrial fibrillation, use of aspirin, perimenopausal hormone therapy, and psychosocial issues are highlighted.
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PMID:Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review. 3243 10

Variants of the posterior intracranial circulation are important for surgeon, interventionalists and radiologists. Herein, a unique configuration of the basilar artery is reported. A 54-year-old man with a history of COPD, hypothyroidism, smoking, and hyperlipidemia presented to an outside institution with nausea, confusion, altered mental status, and ataxia. The patient was evaluated for stroke. Imaging revealed rotation of the basilar apex of 180 degrees, fetal configuration of the posterior communicating artery, right posterior cerebral artery filling from the left vertebral artery, and duplication of the left and right superior cerebellar arteries. The patient continued to deteriorate neurologically and MRI revealed multifocal and symmetric signal abnormalities in the brain stem, thalami, basal ganglia, and hippocampi. The differential diagnosis included acute disseminated myeloencephalitis. Despite plasma exchange and steroid therapy, the patient died a few days later. This case report demonstrates a rare variation of the basilar apex.
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PMID:A unique finding of the basilar artery. 3313 Sep 77


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