Value of screening for secondary causes of hyperlipidaemia in general practice

Evans, Philip; Gray, Denis Pereira

doi:10.1136/bmj.309.6953.509

Cited by 15 publications

(6 citation statements)

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“…A comprehensive clinical and biochemical assessment is important to reveal the possible cause(s) of the dyslipidaemia where secondary lipaemia may be involved [24][25][26], thus affording a potential cure. Nawawi et al [27] reported that possible underlying causes of lipaemia were detected in a majority of elderly Caucasian referrals to a cardiovascular lipid service.…”

Section: Discussionmentioning

confidence: 99%

Current Status of Coronary Risk Factors Among Rural Malays in Malaysia

Nawawi

Nor

Noor

et al. 2002

European Journal of Cardiovascular Prevention & Rehabilitat

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Background Coronary heart disease (CHD) is the leading cause of death in Malaysia, despite its status as a developing country. The rural population is thought to be at low risk.Objective To investigate the prevalence of risk factors and global risk profile among rural Malays in Malaysia.Methods We studied 609 rural Malay subjects (346 females, 263 males; age range 30-65 years). Blood pressure (BP), body mass index (BMI), waist-hip ratio (WHR), smoking habits and family history of premature CHD were documented. Fasting blood samples were analysed for serum lipids, lipoprotein (a), plasma glucose and fibrinogen. Oral glucose tolerance tests were performed using 75 g anhydrous glucose.Results The prevalence of hypercholesterolaemia for total cholesterol concentrations of ! 5.2, !6.5 and !7.8 mmol/l were 67.3, 30.5 and 11.8% respectively. There was a high prevalence of low serum high-density lipoprotein cholesterol (13.1%), hypertension (30.3%), smokers (24.4%), diabetes (6.4%), impaired fasting glucose or glucose tolerance (13.9%), overweight or obesity (44.7%) and increased WHR (48.5%). Global risk assessment showed that 67.3% of the study population were at risk, with 15.9, 18.9 and 32.5% in the mild, moderate and high risk categories respectively.Conclusion Prevalence of risk factors was high in the rural population. Global risk assessment showed a high-risk profile with two-thirds being at risk, and one-third being categorized into the high-risk group. Although rural communities were considered at low risk of developing CHD, this is changing fast, possibly due to the rapid socio-economic development, in addition to underlying genetic predisposition.

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Section: Discussionmentioning

confidence: 99%

Current Status of Coronary Risk Factors Among Rural Malays in Malaysia

Nawawi

Nor

Noor

et al. 2002

European Journal of Cardiovascular Prevention & Rehabilitat

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“…44 Although the prevalence of secondary causes would therefore appear to be low overall, the prevalence of laboratory abnormalities that may be relevant to lipid management is far greater. The prevalence of secondary causes appears to be considerably greater as lipid parameters rise.…”

Section: Post-test Assessmentmentioning

confidence: 99%

Best practice in primary care pathology: review 3

Smellie

2006

J Clin Pathol

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This tenth best practice review examines four series of common primary care questions in laboratory medicine: (i) antenatal testing in pregnant women; (ii) estimated glomerular filtration rate calculation; (iii) safety testing for methotrexate; and (iv) blood glucose measurement in diabetes. The review is presented in question-answer format, referenced for each question series. The recommendations represent a précis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence-based medicine reviews, supplemented by Medline Embase searches to identify relevant primary research documents. They are not standards but form a guide to be set in the clinical context. Most are consensus rather than evidence-based. They will be updated periodically to take account of new information.

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“…The effectiveness of screening for hypothyroidism at lower cholesterol concentrations is unclear, but screening would seem justifiable in patients with more severe disease. Secondary conditions associated with hyperlipidaemia seem to be rare in general practice populations11 but more common in hospital clinics. The tests recommended for patients whose lipids are within the population reference range are justified in patients who are being assessed for lipid lowering treatment on the basis of having additional coronary risk factors and risk factors.…”

Section: Evidence Notementioning

confidence: 99%

Testing pitfalls and summary of guidance in lipid management

Smellie

2006

BMJ

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Value of screening for secondary causes of hyperlipidaemia in general practice

Cited by 15 publications

References 0 publications

Current Status of Coronary Risk Factors Among Rural Malays in Malaysia

Current Status of Coronary Risk Factors Among Rural Malays in Malaysia

Best practice in primary care pathology: review 3

Testing pitfalls and summary of guidance in lipid management

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