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1 Dyslipidemia Jonecia Mack South University NSG5003 Advanced Pathophysiology Case Study 2 Sandi Mcdermott November 12th, 2023
2 Case Study 2 Dyslipidemia is referred to as a high amount of lipids in the blood (Dlugasch & Story). Hyperlipidemia is another name for dyslipidemia. Fats also known as triglycerides, cholesterol and phospholipids are the lipids included in the blood (Dlugasch & Story). Cholesterol is interchangeably used with fats and in place of lipids although they are different (Dlugasch & Story). Elevated lipid levels are linked to cardiac diseases that puts people at a substantial risk for stroke, coronary artery disease, hypertension and atherosclerosis and other heart disorders (Dlugasch & Story). Symptoms of dyslipidemia are related to the disease it is accompanied by. Dyslipidemia itself is asymptomatic (Dlugasch & Story). Lipid abnormalities can be detected by lipid profiles and cholesterol screenings (Dlugasch & Story). Testing such as ultrasounds, and angiographies can be done to diagnose other diseases and abnormalities related to dyslipidemia (Dlugasch & Story). The total cholesterol and LDL’s diagnostic values can risk for atherogenesis (Dlugasch & Story). Atherogenesis refers to the physiology of plaque formation which leads to coronary artery disease (Cichoń, et Al, 2017). Bad cholesterol is referred to as LDL’s. A lipid panel with an LDL greater than 100 is not optimal (Dlugasch & Story). A total cholesterol greater than 200 is considered a high lab value. Lipoprotein sub-fractions cholesterol carrying lipids that travels through the bloodstream to cells (CDC, 2022). Lipoprotein subtractions and apolipoprotein are considered elevated when results on a lipid profile shows an apolipoprotein of 120mg/dl when the optimal range is less than 80mg/dl (Dlugasch, & Story, 2019). Lipoprotein sub-
3 fractions includes LDL particle number with the optimal value been less than 1,260, LDL small with an optimal value less than 162, LDL medium with an optimal value being less than 201 and HDL large with an optimal value being greater than 9,386 (Dlugasch, & Story, 2019). High-density lipoprotein (HDL) is a negative predictor of cardiovascular disease (Nagao, et Al, 2018). The optimal level of HDL’s is greater 40 (Dlugasch, & Story, 2019). The atherosclerotic cardiovascular disease risk score is a national guideline developed by the American College of cardiology to calculate someone’s risk of having cardiovascular problems within 10 years (ACC, 2019). The risk score is determined by race, gender, age, total cholesterol, HDL-C, systolic blood pressure, medication use and smoking status (Dlugasch, & Story, 2019). For example, A 61-year-old white male with a blood pressure of 134/67, total cholesterol of 224 mg/dl and a HDL-C of 55 mg/dl will have an estimated ASCVD score of 10%. A patient with dyslipidemia and a ASCVD score of 10% should implement some lifestyle changes. Lifestyle recommendations should include increasing physical activity and following a low saturated fat diet, that consists of an adequate amount of fruit and vegetable as well as whole grains. Physical activity should be done for 30 minutes at least 2-3 days weekly. Refraining from drinking and smoking is recommended along with a heart healthy diet.
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4 References American College of Cardiology. (2019). Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator Plus. Retrieved February 17, 2021, from https://tools.acc.org/ASCVD-Risk- Estimator-Plus/ Centers for Disease Control and Prevention (2022). Genomics and Precision Health. https://www.cdc.gov/genomics/disease/lipoprotein_a.htm Cichoń, N., Lach, D., Dziedzic, A., Bijak, M., & Saluk, J. (2017). Procesy zapalne w aterogenezie [The inflammatory processes in atherogenesis]. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego, 42(249), 125–128. Dlugasch, L., & Story, L. (2021). Applied Pathophysiology for the advanced practice nurse. Jones & Bartlett Learning, LLC. Nagao, M., Nakajima, H., Toh, R., Hirata, K. I., & Ishida, T. (2018). Cardioprotective Effects of High-Density Lipoprotein Beyond its Anti-Atherogenic Action. Journal of atherosclerosis and thrombosis, 25(10), 985–993. https://doi.org/10.5551/jat.RV17025