Lipid Disorders

Lipids, in particular, LDL cholesterol, lipoprotein(a), and triglycerides, have a very close and steep relationship to major cardiovascular events, such as myocardial infarction, stroke, and death. Elevated lipid levels are due to genetics and/or nutritional factors. Familial hypocholesterolaemia is due to LDL-receptor or PCSK9 mutations which lead to massively elevated LDL-cholesterol and in turn premature myocardial infarction and death. Lipids can be lowered with dietary measures and medication, such as statins, Niemann-Pick C1-like protein 1 inhibitors (Ezetimibe), PCSK9 inhibitors, and, to a lesser degree and primarily triglycerides, by omega 3 fatty acids. Lipid-lowering is recommended in individuals at high risk and patients after major cardiovascular events. Target levels of LDL-cholesterol to be achieved by lipid lowering drugs depend on the individual risk of the patient and vary from <1.0 mmol/l up to 3.0 mmol/l.