Last reviewed:September 2019
Last updated:October  2019

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)
Full details

Treatment algorithm

Contributors

Raul D. Santos

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.

Seth S. Martin

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.

Rhanderson Cardoso

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.

Peer reviewersVIEW ALL

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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