NR 511 - WEEK 7 CLINICAL PRACTICE GUIDELINE PRESENTATION,(2022) DYSLIPIDEMIA - Already Graded A+
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Nursing course
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Nursing Course
I am going to review the clinical practice guideline for the management of dyslipidemia and
prevention of cardiovascular disease that was developed by the American Association of Clinical
Endocrinologist and the American College of Endocrinology.
Dyslipidemia is a broad term that refers to plasm...
I am going to review the clinical practice guideline for the management of dyslipidemia and
prevention of cardiovascular disease that was developed by the American Association of Clinical
Endocrinologist and the American College of Endocrinology.
Dyslipidemia is a broad term that refers to plasma that contains elevated levels of lipids.
It is also considered to be the primary risk factor for the development of cardiovascular disease.
This clinical practice guideline, or CPG, was developed to assist in screening, risk assessment
and treatment of patients with dyslipidemia with the ultimate goal being to reduce the risk of
cardiovascular disease and prevention of atherosclerosis.
First we are going to review some information starting with the epidemiology. According to the
CDC, in 2015 to 2016, 12.4 %, or 31 million adults in the US had a total cholesterol level over
240 mg/dL. This is a reduction from 18% which was present in the year 2000. Overall, this
meets the Healthy People 2020 goal for the prevalence of high total cholesterol to be less than
13.5%, however some groups still do not meet this goal. For example, in the 40-59 age group,
17% of men and 17.7% of women have elevated total cholesterol. There is also cultural
differences in prevalence with 43.1% of Hispanic men and 41.2% of Hispanic women with
having elevated total cholesterol levels.
Regarding the incidence of heart disease, it is estimated that every 40 seconds someone in the
U.S. has a heart attack, which equates to a reported incidence or 790,000 events per year.
Treatment of dyslipidemia, is considered the primary prevention for atherosclerosis.
Next we are going to review the pathophysiology. Atherosclerosis is defined as a buildup of
cholesterol laden plaque within arteries. The pathophysiology behind atherosclerosis is that it is
an inflammatory process that starts with injury to the inner lining of arterial walls due to risk
factors such as smoking or hypertension. This inflammation activates cytokines and allows LDL
to become deposited in the intimal layer of arteries and produce foam cells which is the basis of
atherosclerotic plaques. As the plaque builds up it can cause narrowing of arteries that occludes
blood flow.
One of the challenges with dyslipidemia is that patients are often asymptomatic until it has
progressed to the point where it has caused flow limiting atherosclerosis. At that point, the
patient could present with symptoms such as exertional chest pain, lower extremity claudication
as is seen in peripheral vascular disease, or TIA’s. Physical assessment findings that may be
present are arcus senilis, xanthelasma, or carotid bruits but these findings they may not be
present in every patient with dyslipidemia. In fact, most patients with dyslipidemia are
asymptomatic and that is why screening has such an important role in the treatment and
prevention of both dyslipidemia and cardiovascular disease.
This CPG was developed by the board of directors of the American Association of Clinical
Endocrinologists, or the AACE, and the Board of Trustees of the American College of
Endocrinology. The authors are all physicians who are members of the AACE, are credentialed
in endocrinology, and have attested that they do not have a financial association that is being
promoted with this CPG. The CPG was developed through initial review of current evidenced
based studies by the authors, and subsequent review by remaining members the CPG committee.
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