Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- family history of early onset of coronary heart disease or dyslipidaemia in first-degree relatives
- history of cardiovascular disease
- consumption of saturated fats and trans-fatty acids
- excess body weight (especially abdominal obesity)
- xanthelasmas
- tendinous xanthomas
Other diagnostic factors
- arcus cornealis with onset before the age of 45 years
- tuberous xanthomas
Risk factors
- insulin resistance and type 2 diabetes mellitus
- excess body weight (body mass index >25 kg/m²)
- cigarette smoking
- hypothyroidism
- cholestatic liver disease
- nephrotic syndrome
- use of certain medications
Diagnostic investigations
1st investigations to order
- lipid profile
- serum thyroid-stimulating hormone (TSH)
- lipoprotein(a)
Treatment algorithm
Contributors
Authors

Associate Professor of Medicine
Director Lipid Clinic Heart Institute (InCor)
University of Sao Paulo Medical School Hospital
Scientific Advisor
Hospital Israelita Albert Einstein
Sao Paulo
Brazil
Disclosures
RDS has received honoraria for consulting, speaker activities and research from Astra Zeneca, Amgen, Akcea, Biolab, Esperion, Kowa, Pfizer, Merck, Novo-Nordisk, and Sanofi/Regeneron.

Associate Professor of Medicine/Cardiology
Director
Lipid Clinic
Ciccarone Center for the Prevention of Cardiovascular Disease
Division of Cardiology, Department of Medicine
Johns Hopkins University School of Medicine
Baltimore
MD
Disclosures
SSM has received honoraria from the American College of Cardiology for educational activities. SSM is listed as a co-inventor on a pending patent filed by Johns Hopkins University for a novel method of LDL-cholesterol estimation. SSM received a charitable gift for the VLDL big data project from the David and June Trone Family Foundation, and has also received research support from the PJ Schafer Cardiovascular Research Fund, American Heart Association, Aetna Foundation, iHealth, Stanford MedX/Nokia, Google, and Apple. SSM has acted as a consultant for Abbott Nutrition, Pressed Juicery, Quest Diagnostics, Sanofi/Regeneron, Amgen, Novo Nordisk, Esperian, Akcea, and the Pew Institute.

Cardiovascular Fellow
Pollin Prevention Fellow
Ciccarone Center for the Prevention of Cardiovascular Disease
Division of Cardiology, Department of Medicine
Johns Hopkins University School of Medicine
Baltimore
MD
Disclosures
RC declares that he has no competing interests.
Dr Raul D. Santos, Dr Seth S. Martin, and Dr Rhanderson Cardoso would like to gratefully acknowledge Dr Martin Engelhardt and Dr Michael Miller, the previous contributors to this topic.
Disclosures
ME declares that he has no competing interests. MM has received research grant support and honoraria for lectures from AstraZeneca, Merck-Schering Plough, and Pfizer. MM has received consulting fees from Pfizer, Merck-Schering Plough, and Roche.
Peer reviewers
Assistant Professor of Medicine
Noninvasive Cardiology
MetroHealth Campus
Case Western Reserve University
Cleveland
OH
Disclosures
MLA declares that he has no competing interests.
Consultant/Senior Lecturer in Diabetes & Metabolism
The Royal Oldham Hospital & University of Manchester Cardiovascular Research Group Diabetes Centre
Royal Oldham Hospital
Oldham
UK
Disclosures
DB declares that he has no competing interests.
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