Screening for lipid disorders
- Sandeep Vijan, MD
Sandeep Vijan, MD
- Professor of Internal Medicine
- University of Michigan
- Section Editors
- Mason W Freeman, MD
Mason W Freeman, MD
- Section Editor — Lipids
- Professor of Medicine
- Harvard Medical School
- Joann G Elmore, MD, MPH
Joann G Elmore, MD, MPH
- Editor-in-Chief — Primary Care (Adult)
- Section Editor — General Medicine
- Professor of Medicine, Adjunct Professor of Epidemiology
- University of Washington School of Medicine
Screening for lipid abnormalities is widely recommended and practiced in industrialized nations. While a narrow view of screening would suggest that evaluation for dyslipidemia is primarily aimed at identifying those who are candidates for lipid-lowering therapy, a more appropriate view is that lipid testing provides one component of the assessment of overall cardiovascular risk and helps to identify those who are likely to benefit from any of several different interventions, such as aspirin and antihypertensive therapy, that lower cardiovascular risk. Lipid-lowering therapy, at least with statins, is one key component of a comprehensive plan to improve cardiovascular outcomes. (See "Overview of primary prevention of coronary heart disease and stroke".)
Generally, screening programs rely on several key features. The disease being identified early (or prevented) needs to be serious, pre-clinical conditions should be common and asymptomatic, and early treatment should have proven benefit (see "Evidence-based approach to prevention") . These conditions are all met in the case of lipid screening:
●Coronary heart disease (CHD) and related conditions, such as stroke, are the most common cause of morbidity and mortality in industrialized nations [2,3].
●Dyslipidemia is typically asymptomatic, but is common and an important predictor of CHD risk [4,5].
●There are a variety of treatments that are effective in lowering the risk of primary CHD risk [6,7].
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- RELATIONSHIP BETWEEN LIPIDS AND CHD RISK
- Whom to test
- - Higher risk
- - Lower risk
- Estimating the probability of cardiovascular events
- Choice of tests
- Frequency of testing
- Stopping screening
- RECOMMENDATIONS OF OTHERS
- SUMMARY AND RECOMMENDATIONS