Hypothyroidism As A Major Contributor To Hyperlipidemia
Criteria
1.Synthesize relevant information, including research related to the diagnosis and treatment of the selected disorder.
2.Recognize the assumptions inherent in the current literature and identify any unstated or missing information.
3.Develop and justify various approaches to the stated problem, including nonpharmacological and pharmacological treatment.
4.Clearly articulate at least two approaches to the treatment of the condition.
5.Defend the choice of the treatment option. This must include a reflection on the availability of peer-reviewed information and your analysis of the credibility of that information.
6.Create a plan for follow-up and referral if needed.
Grading Criteria
Described the pathophysiology of the disease process in depth. Included a discussion of the implications of the age continuum for this disease.
Discussed the genomic issues inherent in the disease process, including what is known and what is not known.
Provided a review of the literature on the basics of the disease and its treatment.
Described your approach to collecting this needed information. Included what keywords you used in a literature search, which databases were utilized, and any electronic clinical tools.
Identified and utilized at least one published clinical guideline related to the disease process.
Described the approach to the treatment of the specific disease, including the various possible approaches.
Defended the final selection of the approach for the disease process.
Discussed follow-up treatment, along with any referrals.
Utilized a minimum of five peer-reviewed articles published within the last seven years.
Hyperlipidemia
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Introduction
Hyperlipidemia also known as hypercholesterolemia or high cholesterol tends to be the major risk factor for the heart disease. In the US, the condition has been termed as the leading cause of death. One in every three of Americans is affected (Davis, 2017).There are two types of hyperlipidemia; low-density lipoprotein (LDL) and high-density lipoprotein (HDL). The earlier is referred to as bad cholesterol while the later is good cholesterol. Hypothyroidism is a major contributor to hyperlipidemia. To lower LDL and raise HDL, regular exercise is recommended. This paper synthesizes information from the existing literature and identifies gaps in the literature that require further research. It also discusses the diagnosis and treatment of hyperlipidemia.
Literature Review
Studies by Nelson Robert 2013, suggest that the major risk factor for cardiovascular disease is hyperlipidemia. The study also suggests that the treatment of the condition is based on the guidelines of the National Cholesterol Educational Panel’s (NCEP) Adult Treatment Program-3 (ATP-III). To raise the LDL-C, statins are the best-recommended category of drugs. To substitute Statins, other categories of drugs are used. They include; dietary supplements, niacin, fibrates, and ezetimibe. The study too suggests that the aggressiveness of the ATP-III guidelines is still questionable. There are ATP-IV guidelines, but they have not been put into practice yet. There are some uncertainties that the physicians are still facing. The lowest level of targeting LDL-C is uncertain. There is no assurance if HLD-C should be treated pharmacologically among others.
Studies by Mannu, Zaman, Rehman & Myint (2013) affirm that the leading cause of death in the world is Coronary Heart Diseases (CHD). The major causality of CHD is hypercholesterolemia. Non-pharmacological methods which include lifestyle modification provide both long-term and initial measures through which the issue can be addressed. This was a systematic search study of Medline/PubMed which involved an approach that can be described as two-tier. It was limited to the materials written in English. It involved reviewing more than 3600 reports. The results indicate that change in lifestyles regarding dietary habits, physical activities, and weight reduction helped to achieve the target level of cholesterol in the body. Constituents of dietary for instance green tea, soy protein and plant sterols played a vital role in achieving these goals. The pharmacological interventions were recommended where non-pharmacological interventions did not work for a period of 3 weeks.
Studies by Shattat 2017, suggest that hyperlipidemia serves as a major risk factor for contracting the cardiovascular disease. The major anti-hyperlipidemia stands to be statins and fibrates for the treatment of triglycerides and plasma cholesterol that is elevated. However, there is a potential treatment from other agents such as the following. The agents include; ATP citrate lyase inhibitors, diacyl glycerol acyl transferase inhibitors, squalene epoxidase inhibitors and lanosterol synthase inhibitors. This was a study that focused on reviewing hyperlipidemia types, metabolism of the lipids, treatment of hyperlipidemia and the new target drugs.
Studies by Shah, Mason, Kurt, Denton, Schaefer, Mintori & Smith 2011, indicate that despite the guidelines of the treatment of hyperlipidemia being numerous and existing in various countries such as Australia, Europe, and America, the effectiveness of these guidelines are unclear. This was a study that was based on the comparison of the effectiveness and the efficiency of international guidelines for treating hyperlipidemia and hypertension on Diabetes type 2 patients aged 40-80 years. The findings show that the effectiveness of all international guidelines are equally effective. The difference comes in the medical cost. The medical cost is unclear.
Assumptions of the Current Literature
One of the major assumptions of the current literature is on the guidelines of hyperlipidemia treatment. Literature assumes that the guidelines are effective but ‘how effectiveness' is this ‘effectiveness' has not been established yet. Studies by Shah Et.al 2011 only show effectiveness when in comparison, but the effectiveness of serving the purpose is not clear. Also, the lowest level as seen in the studies by Nelson 2013 that physicians should maintain the cholesterol levels is not clear. If the High-Density Lipoprotein Cholesterol should be treated via pharmacological intervention is also missing in the literature.
Thus, more studies need to be conducted to fill the gaps. Studies on the effectiveness of the guidelines must be conducted and relevant information put in the foreseen ATP-IV that is expected in the future. Studies on the lowest level of cholesterol that should be maintained in the body should be conducted to ascertain the medical practitioners. Studies on the effectiveness of pharmacological interventions in treating HDL-C as compared to non-pharmacological interventions should be distinctly established.
Hyperlipidemia Treatment Approaches
Pharmacological Treatment
Statins and fibrates are the most effective treatment for hyperlipidemia and thus the primary and secondary cardiovascular disease prevention. Statins have been known to be effective especially in the primary prevention in patients who at a high risk. Patients who have a risk equivalent of contracting a cardiovascular disease or those with the disease are also recommended to take statins. The patients with acute coronary syndromes should take high-dosage of statins. There are patients who are allergic or for another reason cannot tole...