Abstract
Cholesterol is one of several modifiable risk factors for cardiovascular disease.
Others include high blood pressure and smoking, which will need monitoring to manage overall cardiovascular risk. However, in this chapter, we shall
confine ourselves to considering how and when to monitor lipid profiles in
patients with hyperlipidaemias taking an HMG-CoA reductase inhibitor (a
‘statin’). We shall not discuss the question of how or even whether to monitor
the use of statins in preventing cardiovascular disease in apparently healthy
individuals. The mechanism of action of statins is illustrated in Figure 18.1.
Cholesterol monitoring is now a common clinical activity. With widening
indications for treatment over the past decade, cholesterol-lowering medications gave become the highest-cost pharmaceutical items in the National
Health Service in the UK. Correspondingly, cholesterol screening, treatment, and lipid monitoring have increased. For example, in Oxfordshire there was
a 2.5-fold increase in the total number of cholesterol tests performed between 1996 and 2004, making serum cholesterol the most common single test
ordered (J Kay, T James, personal communication).
Summary
This chapter contains sections titled:
- Why should we monitor lipids in patients with hyperlipidaemias?
- Choosing the Main Lipid Measurement for Monitoring
- Initial Response to Treatment
- Maintenance Schedule
- Conclusions
- Acknowledgements
- References
Others include high blood pressure and smoking, which will need monitoring to manage overall cardiovascular risk. However, in this chapter, we shall
confine ourselves to considering how and when to monitor lipid profiles in
patients with hyperlipidaemias taking an HMG-CoA reductase inhibitor (a
‘statin’). We shall not discuss the question of how or even whether to monitor
the use of statins in preventing cardiovascular disease in apparently healthy
individuals. The mechanism of action of statins is illustrated in Figure 18.1.
Cholesterol monitoring is now a common clinical activity. With widening
indications for treatment over the past decade, cholesterol-lowering medications gave become the highest-cost pharmaceutical items in the National
Health Service in the UK. Correspondingly, cholesterol screening, treatment, and lipid monitoring have increased. For example, in Oxfordshire there was
a 2.5-fold increase in the total number of cholesterol tests performed between 1996 and 2004, making serum cholesterol the most common single test
ordered (J Kay, T James, personal communication).
Summary
This chapter contains sections titled:
- Why should we monitor lipids in patients with hyperlipidaemias?
- Choosing the Main Lipid Measurement for Monitoring
- Initial Response to Treatment
- Maintenance Schedule
- Conclusions
- Acknowledgements
- References
| Original language | English |
|---|---|
| Title of host publication | Evidence-based Medical Monitoring: From Principles to Practice |
| Editors | Paul P. Glasziou, Les Irwig, Jeffrey K. Aronson |
| Place of Publication | Carlton |
| Publisher | Blackwell Publishing Asia |
| Pages | 245-253 |
| Number of pages | 9 |
| ISBN (Electronic) | 9780470696323 |
| ISBN (Print) | 9781405153997 |
| DOIs | |
| Publication status | Published - 1 Apr 2008 |
| Externally published | Yes |
