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  1. Hyperlipidemia John Baer

  2. What is it? • Hyperlipidemia- any condition that elevates fasting blood triglyceride and cholesterol concentrations • Dyslipidemia- altered blood lipid and lipoprotein concentrations • Hypercholesterolemia- elevated cholesterol • Hypertriglyceridemia- elevated triglycerides • Hyperlipoproteinemia- elevated lipoproteins • Hypoalphalipoprotein syndrome- low HDL • Postprandial lipemia- postprandial rise in TG rich proteins after eating

  3. Understanding • http://www.youtube.com/watch?v=NklmCp8pyDM

  4. Epidemiology • On the decline • Average cholesterol went from 213 mg/dl to 203 mg/dl (1978-1994) • 17% of adults have cholesterol 240 mg/dl or greater • 67.6% had blood checked in 1991 • 73.1% had blood checked in 2003 • Greater awareness

  5. Symptoms • Cholesterol greater than 240 mg/dl • LDL often over 260 mg/dl • HDL lower than 40 mg/dl

  6. Testing • Obtained through complete blood lipid profile from forearm venipuncture following a 12 hour fast • Finds total cholesterol, LDL-C, HDL-C, and triglycerides.

  7. Complications • Dyslipidemia itself is not a complication • Patients with dyslipidemia may also have other diseases or disabilities which may prevent them from exercise • A thorough medical review must be conducted before any exercise training

  8. Treatment • Lifestyle changes • Medications

  9. Lifestyle Changes • TLC diet, therapeutic lifestyle changes • Fat intake 25-35% total calories • Saturated fat less than 7%, polyunsaturated fat 10%, and monounsaturated fat 20% of calories • Increases in dietary fiber and plant stanols or sterols • Encouraged to eat more fruits, vegetables, and high fiber foods

  10. Lifestyle Changes cont. • Smoking cessation • Exercise

  11. Medications • If lifestyle changes are not working well enough for 6 months medications used • Statin agents are most commonly used • Increase HDL and decreases LDL • Inhibits cholesterol synthesis

  12. Effects of Disease on Exercise • Dyslipidemia alone does not affect exercise • Cardiovascular disease could cause angina • Medications currently taking

  13. Medications on Exercise • P. 43 Clinical Exercise Physiology

  14. Effects of Exercise on Disease • Lower triglyceride concentrations • Reduced postprandial lipemia • Decreased concentrations of LDL • Higher HDL concentrations • Increases in lipoprotein enzyme activity • Improved glycemic control • Reduction in adiposity indirectly lowers blood lipid concentrations • P. 225 Pollock’s

  15. Exercise Testing • Follow protocols for populations at risk for CAD • Diagnose CAD • Determine functional capacity • Determine appropriate intensity range for aerobic exercise training • High cholesterol may cause ischemia

  16. Exercise Programming • Aerobic exercise is the foundation of the program • Exercise at 40-80% VO2 max • 5 or more days per week • Once, maybe twice per day • Incorporate resistance training in program • 45 minutes per session • P. 172 ACSM

  17. Conclusions • Have blood lipids checked every 1-5 years • Could prevent CAD and atherosclerosis • Eat healthy and exercise

  18. References • Know the Risks: Lifestyle Management of Dyslipidemia by Paul Sorace, Thomas LaFontaine, and Tom R. Thomas • ACSM’s Exercise Management for Persons With Chronic Diseases and Disabilities by J. Larry Durstine, Geoffrey E. Moore, Patricia L. Painter, Scott O. Roberts • Clinical Exercise Physiology 2nd Edition by Jonathan K. Ehrman, Paul M. Gordon, Paul S. Visisch, Steven J. Keteyian • Pollock’s Textbook of Cardiovascular Disease and Rehabilitation by J. Larry Durstine, Geoffrey E. Moore, Michael J. LaMonte, Barry A. Franklin • http://www.google.com/imgres?um=1&hl=en&biw=1235&bih=564&tbm=isch&tbnid=kZADRt5miFTF5M:&imgrefurl=http://www.medscape.com/viewarticle/480603_3&docid=Qk1E4OGh_l4YUM&imgurl=http://img.medscape.com/fullsize/migrated/480/603/cvrr480603.tab1.gif&w=675&h=614&ei=eJZCT_bYNcKsiQLC8PGYAQ&zoom=1&iact=hc&vpx=402&vpy=29&dur=3444&hovh=214&hovw=235&tx=123&ty=93&sig=113826194840513614201&page=1&tbnh=115&tbnw=126&start=0&ndsp=22&ved=0CEsQrQMwAg • http://health-club.org/heart-disease-risk-factor