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Fast Facts: Hyperlipidemia, 5th edn

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Fast Facts: Hyperlipidemia, 5th edn

By Allan Sniderman and
Paul Durrington

Published 2010

144 pages, 34 illustrations

ISBN 978-1-905832-63-7

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Fast Facts: Hyperlipidemia provides a crisp and accurate summary of lipid disorders using clear language and illustrations. Directed at a broad range of healthcare professionals, from primary care physicians to specialists, this updated fifth edition addresses the importance of considering lipoprotein particles, not just their lipids.

The authors, renowned experts from the UK and USA, interpret clinical trial evidence in the context of pathogenesis and provide practical solutions to the routine problems encountered in the clinical management of hyperlipidemias.

Contents

  • Lipids and lipoproteins - structure and physiology
  • Epidemiology and pathophysiology
  • Familial (monogenic) hypercholesterolemia
  • Polygenic hypercholesterolemia and combined hyperlipidemia
  • Hypertriglyceridemia
  • Familial dysbetalipoproteinemia
  • Dyslipidemia in insulin resistance, the metabolic syndrome and diabetes mellitus
  • Secondary hyperlipidemia
  • Dietary treatment
  • Drug treatment
  • When to treat
  • Biochemical tests
  • Useful resources

Review
'Thank you for such a well-written informative book. It was exactly what I needed to clarify what has up to now been a confusing subject.'Dr Hugh O'Neal (Geriatrics, Worthing)

 

The authors

Allan Sniderman

MD FRCP(C) Edwards Professor of Cardiology and Professor of Medicine, McGill University, Montreal, Canada


Paul Durrington

MD FRCP FRCPath FMedSci Professor of Medicine, Cardiovascular Research Group, School of Clinical and Laboratory Science, University of Manchester, UK


 

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Comments for the authors


Kit Byatt, United Kingdom 18 Apr 2015

One caveat (re statin use in the over-80s), in an otherwise excellent resource!
The only prospective trial specifically looking at this group (PROSPER, 2002) showed NO statistically significant stroke reduction on up to 3.5 years' treatment.
Also, many patients aged over 80 (especially if frail, or with multiple co-morbid conditions - and associated treatments) would not have been included in this trial; we should be very careful about extrapolating from the trial population to others without very careful thought.
There are very few *absolute* indications, even in the healthy elderly. Each patient has to be treated on her/his merit, bearing the evidence in mind.

====================
Reference
Byatt K.
Overenthusiastic stroke risk factor modification in the over-80s: are we being disingenuous to ourselves, and to our oldest patients?
Evidence-based medicine. 2014 Aug;19(4):121-122.

 

Noura Alnowaiser, Saudi Arabia 06 May 2015

A practical reference guide to current evidence about Hyperlipedemia

 

Allan Sniderman, Canada 07 May 2015

Reply to Kitt Byatt, United Kingdom, 18Apr 2015:

"Thank you.
A thoughtful and collaborative critique.
best
allan"

 

Shashi Seshia , Canada 28 May 2015

(i) Overall a very useful book, with a lot of current data. The chapters on pages 7, 19 and 133 are excellent, especially the one on biochemical tests: good simple points about some limitations related to interpretation.
(ii) I believe the information about the side-effects of statins is simplistic. On the other hand this book was last published /edited in 2010 and may be out of date. There is no reference to the controversies/debates re statins: some groups feel that the incidence of side-effects is greater in the population at large than in the trials.
(iii) Would be important for authors to declare their financial CoIs.
(iv) Would be important for publishers to declare financial CoIs. The book was a 'freebie' at the Evidence Live 2015 conference. How is Health Press funded if these books are distributed without cost?
yours sincerely,
Shashi Seshia

 

Elke Streit, United Kingdom 28 May 2015

I found the “Fast Facts” book on hyperlipidemia very useful. The chapter on Familial Hyperlipidemia was particularly useful.

 

Paul Durrington, United Kingdom 29 May 2015

I do not favour insisting that elderly people receive statins and I cannot find that we said that. I agree with Kit Byatt's sentiments and do not believe that the clinical decision to introduce a statin (which should be negotiated carefully with our patients, particularly at the two ends of the age spectrum) is simply a matter of clinical trials. I am also grateful for Dr Byatt's praise for our small book, but I must disagree with his interpretation of the evidence. PROSPER is not the only trial of statins in the elderly. As was pointed out at the time of publication, there were more elderly people randomized in the Heart Protection study and, of course, meta-analyses, such as those of the Cholesterol Treatment Trialists, have even more older participants and leave no doubt that statins decrease atherosclerotic cardiovascular events in the elderly [references in Chapter 10]. If an older person has had a revascularization procedure, it seems perverse not to offer a statin. In primary prevention many older people are wary of statins, having done alright so far and not wanting to upset the applecart. The extension of life statins bring gets less as we get older, and then we may be exposed to some other illness (not statin related as the trials show) we would rather not have survived long enough to develop. I am also concerned that even the most recent guidelines promote statins in older people and neglect younger ones even when they have a high cholesterol. Table 10.1 attempted to address this to some extent. I think we would say a lot more about this issue, if there was ever another iteration of our book.
Best wishes,
Paul Durrington

 

Huw Llewelyn, United Kingdom 04 Jun 2015

There is one point that I would like your help to try to clarify. On page 100 of 'Fast Facts' there is an assertion that there is a 19% reduction in risk of stroke for each 1mmol/l reduction in HDL.

Can you please tell me how this was calculated and what published data and assumptions were used in the calculation.

Please also describe the calculations, source data and definitions for 'CHD' and how the RRR of 23% was arrived at (and the RRR of 21% for CVD).

Have the relevant risks with and without treatment with statins been calibrated against observed rates of CVD, CHD and stroke in a separate population over 10 years or some other time interval?


Huw


 

Mutaz. R. alsabah, Iraq 17 Dec 2015

Great !! this book is one of the books I was searching for since years !

I am eagerly waiting 2016 edition to be published

 

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