Hyperlipidemia Management for Primary Care: An Evidence-Based Approach

ISBN-13: 9780387766058 / Angielski / Miękka / 2008 / 228 str.

Brian V. Reamy

Opis

One of the possible bene?ts of 30 years of medical practice is the ability to develop some sense of perspectivewith regardto majortransitionsin medicine. Manyphy- cians who graduated from medical school in the mid- to late 1970s may recall fe- ing less than comfortable about counseling patients regarding lifestyle modi?cation and heart disease risk. A total cholesterol of 250 mg% at that time was considered within normal limits. The best information on the causation of heart disease came from epidemiologic data showing associations between increased consumption of dairy products and fat in the industrialized countries of northern Europe and Am- ica, and a corresponding increase in morbidity and mortality from heart disease as compared to other countries that were less well developed or as compared to Mediterranean countries, where there was a different type of diet lower in saturated fats and cholesterol. Treatment options in those days were based more on anecdotal information and observation than on evidence. The idea that coronary artery disease was an in?- matory problem in which the main culprit was oxidized LDL and the idea that heart disease risk could be managed had not yet made the transition to clinical pr- tice. This attitude all changed as information from the largest and longest running prospective epidemiologic study on heart disease the Framingham Study began publishing data on causality and risk factors."

Spis treści

OVERVIEW OF EVIDENCE SUPPORTING TREATMENT OF HYPERLIPIDEMIA. Pre-statin trials. Primary prevention statin trials. Secondary prevention statin trials. Other trials. Normal Lipid Values. NCEP/ATP-III GUIDELINES. Review of ATP-III for treatment of hyperlipidemia. Review of 2004 ATP-III update. Review of ATP-IV. LIFESTYLE CHANGES AND NON-DRUG TREATMENT. Weight loss and other diets--benefits and risks. Therapeutic foods. Exercise interventions--benefits and risks. DRUG TREATMENT. General principles of drug treatment of hyperlipidemia. Agents (action, dosing, side effects, unique uses). Drug interactions. Drug intolerance and severe side effects. Drugs of the future. SPECIAL POPULATIONS AND SITUATIONS. Elderly patients .-Patients with multiple medical problems. Women. Adults younger than 35 years of age. Children. Elite athletes. Native Americans. Immigrants. Family issues. Community issues and population health concerns. OTHER ISSUES IN PREVENTION OF CARDIOVASCULAR DISEASE. Aspirin prophylaxis. Novel screening tools for risk assessment. PRACTICAL APPROACH TO THE PATIENT WITH HYPERLIPIDEMIA. Treatment algorithms. Visit and serum testing frequency. Compliance and motivational tools. Referral guidelines for refractory hyperlipidemia. CASE STUDIES. The well elderly patient. The well young patient. The diabetic. The patient with intermediate risk. The unreachable goal. Kids. Normal cholesterol, but high TG and low HDL. Can't use statins. Metabolic syndrome. FUTURE DIRECTIONS. How low do you go? PPARs and prevention of metabolic syndrome. Integrative treatment (diet + exercise + drugs).

O autorze

Lipid disorders impact an estimated 42 to 50 million adults in the United States, yet many primary care physicians are not optimally treating this growing population. This superb volume is a major contribution to the treatment of this genre of disorders. It is a comprehensive resource for primary care providers that offers information and treatment options that can be incorporated with ease into everyday clinical practice. This evidence-based text weighs the benefits of pharmacologic treatments, popular diets, therapeutic foods, herbs and vitamins as a means to manage hyperlipidemia. A section dedicated to treating special populations examines the particular needs of elderly patients, women, athletes and other unique groups. Complete with clinical case studies to illustrate real-life patient scenarios, Hyperlipidemia Management for Primary Care is a handy reference for any physician seeking clear cut information on this increasingly common condition.

Blurb

Lipid disorders impact an estimated 42 to 50 million adults in the United States, yet many primary care physicians are not optimally treating this growing population.  Hyperlipidemia Management for Primary Care: An Evidence-Based Approach is a comprehensive resource for primary care providers that offers information and treatment options that can be incorporated with ease into everyday clinical practice.  This evidence-based text weighs the benefits of pharmacologic treatments, popular diets, therapeutic foods, herbs and vitamins as a means to manage hyperlipidemia.  A section dedicated to treating special populations examines the particular needs of elderly patients, women, athletes and other unique groups.  Complete with clinical case studies to illustrate real-life patient scenarios, Hyperlipidemia Management for Primary Care is a handy reference for any physician seeking clear cut information on this increasingly common condition.