Managing Dyslipidaemia Essay Discussion Paper
Lazarte & Hegele (2020) argue most patients with diabetes have common patterns of dyslipidemia characterized by decreased HDL cholesterol levels and elevated triglyceride levels. Also, have significant changes in LDL cholesterol. Based on the National Cholesterol Education Program, the patient is at the borderline of high risk with Total cholesterol of 210 mg/dL, LDL of 120mg/dL, and HDL of 47 mg/dL. This condition puts the patient at risk of contracting Coronary Heart Disease. From the first visit, the patient has significantly improved after the focus on her lifestyle and taking medications; Metformin, ASA and Pravastatin. Managing Dyslipidaemia Essay Discussion Paper
It will be necessary to determine the patient’s BMI during the second visit (4 weeks after the first visit). Weight loss significantly lowers triglycerides, total cholesterol and LDL fraction and raises HDL. The step to be taken will be initiating dietary therapy, Step I and Step II diets. This is because the patient has borderline-high LDL cholesterol levels (Cicero et al., 2019). This initiative will aim to lower the LDL level to or less than 100mg/dL and elevated total cholesterol levels. Managing Dyslipidaemia Essay Discussion Paper
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Further, to reduce the risk of coronary heart disease, NCEP recommends multiple drug therapy. A combination of a cholesterol-lowering drug is considered to lower LDL levels if it remains above the target level after three months while using a single-drug therapy. Also, based on the patient’s gender and age, I will consider estrogen replacement therapy to increase HDL cholesterol level and lower LDL cholesterol level. Since the patient is on pravastatin, a conjugated estrogen will optimize LDL cholesterol levels (Warden & Duell, 2019). Additionally, plasmapheresis is a non-dietary and non-pharmacologic treatment that can be considered to decrease the risk of pancreatitis and dramatically reduce triglyceride levels. Managing Dyslipidaemia Essay Discussion Paper
References
Cicero, A. F., Landolfo, M., Ventura, F., & Borghi, C. (2019). Current pharmacotherapeutic options for primary dyslipidemia in adults. Expert Opinion on Pharmacotherapy, 20(10), 1277- 1288.
Lazarte, J., & Hegele, R. A. (2020). Dyslipidemia management in adults with diabetes. Canadian journal of diabetes, 44(1), 53-60.
Warden, B. A., & Duell, P. B. (2019). Management of dyslipidemia in adult solid organ transplant recipients. Journal of clinical lipidology, 13(2), 231-245. Managing Dyslipidaemia Essay Discussion Paper