Primary Hyperlipidemias and Their Management

Abstract

Determination of relative concentrations of serum cholesterol phospholipid, and triglycerde provided useful information in distinguishing the main clinical types of hyperlipidemia. Abnormal serum lipid levels of 2 main types of hypercholestermia and hyper-glyceridemia are identified by their clinical and laboratory characteristics. Hypercholestermia is subdivided into the "pure" type and the type which is complicated by mild to moderate degrees of hyperglyceridemia. Hyperglyceridemia may be classified into the purely fat-induced, common or mixed, and perhaps the predominantly carbohydrate-induced types. Some patients with coronary artery disease show mild to moderate elevations in all serum lipid fractions. Studies of the post-heparin plasma lipolytic activity and of the fatty acid composition of the depot fat are helpful sometimes in revealing the basic nature of the hyperlipidemic states. Treatment of hyperlipidemic patients should be individualized. In general, appropriate reduction in the total daily caloric intake was more effective than either fat or carbohydrate restriction in the great majority of hyperglycerdemic patients. Heparin, D-thyroxine and nicotinic acid added to the dietary program obtained satisfactory control of the elevated serum lipid levels. It is obvious that our understanding of the effect of diet and drugs on serum lipids and atherosclerosis is not complete. Early diagnosis, long-term control, and follow-up studies of patients with hyperlipidemia should provide useful information concerning the relationship between plasma lipid levels and atherosclerosis.