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Old 03-19-2012
tyagee's Avatar
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Question Hypertensive Patient with Hyperlipidemia!

A 55-year-old man with a long history of hypertension comes to your clinic for a follow-up visit. His blood pressure is well controlled with amlodipine 10 mg once daily and with 25 mg of hydrochlorothiazide. During his recent annual checkup, the laboratory studies showed a total cholesterol of 265 mg/dL, high-density lipoprotein (HDL) cholesterol 31 mg/dL, low-density lipoprotein (LDL) cholesterol of 155 mg/dL, and a triglyceride level of 295 mg/dL. In addition, he has a history of chronic persistent hepatitis secondary to hepatitis B with aspartate aminotransferase level of 75 mg/dL and alanine aminotransferase of 105 mg/dL. His body mass index is 29. He is currently taking no lipid-lowering agents. Which of the following would you do next to correct his hyperlipidemia besides advising weight reduction and exercise?

A. Monitor the effects of exercise and weight reduction along with low-cholesterol diet
B. Prescribe gemfibrozil
C. Prescribe lovastatin
D. Prescribe nicotinic acid
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Old 03-21-2012
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niacin...since it is able to effectively reduce ldl, trigs, and increase hdl....this dude can't take a statin for the liver issues. gemfibrazil i thought only works on lowering tgs.
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Old 03-21-2012
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has 1 risk factor - HTN

so goals are

for >160 ldl is exercise n >190 is a drug

Bt he cant take a statin...LFT is too abnormal

plus

Hdl goal is atleast 40... only niacin primarily seen to improve it..

so Niacin is ans
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Old 03-21-2012
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Quote:
Originally Posted by dr.dhruvdesai View Post
has 1 risk factor - HTN

so goals are

for >160 ldl is exercise n >190 is a drug

Bt he cant take a statin...LFT is too abnormal

plus

Hdl goal is atleast 40... only niacin primarily seen to improve it..

so Niacin is ans
that means the indication for giving niacin is low hdl levels not high ldl levels.
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Old 03-21-2012
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I agree

yes !!

but the drug will help LDL reduction as well !!
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