Lipids—fats made up of cholesterol, triglycerides and other fats—travel in the bloodstream as part of particles that contain specialized proteins. High lipid levels in the blood increase a person’s risk for heart attack, stroke, peripheral vascular disease and other cardiovascular diseases. Lowering cholesterol levels lowers one’s risk of these diseases. In some cases, rare genetic disorders affecting lipids may also lead to harm and require specialist attention.
Froedtert & the Medical College of Wisconsin endocrinologists identify and treat general and specialized cholesterol disorders. Patients may be referred by their primary care physician or cardiologist for a lipid evaluation, or patients may refer themselves.
Diagnosing Cholesterol Disorders
Lipid disorders are diagnosed through a blood test called a lipid profile. A lipid profile measures total cholesterol, HDL (“good”) cholesterol, LDL (“bad”) cholesterol, triglycerides and certain proteins.
An evaluation to assess a patient’s risk for cardiovascular disease and atherosclerosis is also important. Evaluations may be needed when a patient:
- Has trouble lowering his or her cholesterol level with medication
- Is unable to tolerate statins, a type of medication used to lower cholesterol
- Has a genetic disorder that affects lipid levels, such as one that causes high cholesterol or high triglyceride levels from birth, or other lipid abnormalities, such as sitosterolemia
- Has severe hypertriglyceridemia and is at risk for pancreatitis, which carries a high risk of complications and death
Patients may also be screened for secondary disorders, such as hypothyroidism, uncontrolled diabetes, obesity, kidney disease and other conditions that can worsen lipid disorders. Identifying and controlling these disorders can help in overall cholesterol control.
Treatment for lipid disorders is aimed at intense management of cardiovascular risks to prevent heart attacks, stroke and peripheral vascular disease. Endocrinologists treat most patients using a combination of diet, exercise and medication.
Medical Nutrition Therapy
All patients require nutrition therapy as part of their treatment. Medical nutrition therapy is used to improve diet and dietary habits, as these can have a significant impact on the blood lipid levels. A dietitian assesses the patient’s diet, nutrition and lifestyle, provides nutrition counseling, and discusses how to manage lifestyle factors that affect diet.
Medicines that manage blood cholesterol levels may be prescribed. Many of these have been proven to be effective in large scientific studies.
Exercise is part of an overall plan to improve cardiovascular fitness, improve symptom control in people with peripheral vascular disease and improve overall health.
Follow-up visits after treatment begins are important to assess lipid levels, to determine if patients are tolerating medication and meeting their goals to lower lipid levels, and to assess development of cardiovascular disease.