Hyperlipidemia screening

Hyperlipidemia
ICD-10	E78.
ICD-9	272.0-272.4
DiseasesDB	6255

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Screening and treatment of lipid disorders in people at high risk for future coronary heart disease (CHD) events has been recommended by the, United States Preventive Services Task Force (USPSTF) especially for patients with known CHD. However, the role of screening in people with low to medium risk is controversial. On the basis of the effectiveness of treatment, the availability of accurate and reliable tests, and the likelihood of identifying people with abnormal lipids and increased CHD risk, screening appears to be effective in middle-aged and older adults and in young adults with additional cardiovascular risk factors.

Screening Tests

Screening and treatment of lipid disorders in people at high risk for future coronary heart disease (CHD) events has been recommended by the, United States Preventive Services Task Force (USPSTF). However, the role of screening in people with low to medium risk is controversial. Due to the availability of accurate and reliable tests, the likelihood of identifying people with abnormal lipids has increased recently.

2002 United States Preventive Services Task Force (USPSTF) Screening Tests for Lipid Disorders in Adults (DO NOT EDIT)

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1) The preferred screening tests for dyslipidemia are total cholesterol and HDL-C on non-fasting or fasting samples. 2) There is currently insufficient evidence of the benefit of including triglyceride as a part of the initial tests used to screen routinely for dyslipidemia. 3) Abnormal screening test results should be confirmed by a repeated sample on a separate occasion, and the average of both results should be used for risk assessment. 4) Measuring total cholesterol alone is acceptable for screening if available laboratory services cannot provide reliable. 5) Measurements of both total cholesterol and HDL-C is more sensitive and specific for assessing CHD risk than measuring TC alone. 6) In conjunction with HDL-C, the addition of either LDL-C or TC would provide comparable information, but measuring LDL-C requires a fasting sample and is more expensive. 7) Direct LDL-C testing, which does not require a fasting sample measurement, is now available; however, calculated LDL (TC minus HDL minus TG/5) is the validated measurement used in trials for risk assessment and treatment decisions. In patients with dyslipidemia identified by screening, complete lipoprotein analysis is useful.

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Screening Frequency

Screening and treatment of lipid disorders in people at high risk for future coronary heart disease (CHD) events has been recommended by the, United States Preventive Services Task Force (USPSTF) especially for patients with known CHD. However, there is lack of consensus in the screening frequency.

2002 United States Preventive Services Task Force (USPSTF) Screening Frequency for Lipid Disorders in Adults (DO NOT EDIT)

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Clinical Considerations: The optimal interval for screening is uncertain. On the basis of other guidelines and expert opinion, reasonable options include every 5 years, shorter intervals for people who have lipid levels close to those warranting therapy, and longer intervals for those not at increased risk who have had repeatedly normal lipid levels.

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