Lipids

Primary prevention

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In the UK if the 10yr CVD risk is above 20% (in the red region of the chart)  then the patient should be considered for lipid lowering therapy (statin). If the patient is borderline for 20% then other issues such as additional risk factors (eg obesity), whether the patient is almost in the next age group etc should also be used to help guide the decision.

In addition to the use of the charts it should also be remembered that there may be other reasons why the cholesterol is high. This may be -

1. Genetic

Familial hypercholesterolaemia (homozygous) is rare but the heterozygous form is common and should be considered in patients with a total cholesterol above 7.5 mmol/l, a family history of  (early onset) CVD and clinical signs of hypercholesterolaemia (as shown below).

Thickened achilles tendons

Corneal arcus

Xanthelasmata