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Dyslipidemia – Possible Complications

Possible Complications

Dyslipidemia is an important and potentially reversible risk factor for cardiovascular disease, which is associated with HIV infection and its treatment.1 

Very high levels of triglycerides (>11.29 mmol/L [>1000 mg/dL]) are a known but rare cause of pancreatitis in the general population.2 

In individuals receiving pharmacotherapy for dyslipidemia, care should be taken to effectively manage drug-drug interactions to avoid toxicity. Signs of statin toxicity include:3

  • gastrointestinal symptoms
  • headache
  • insomnia
  • rhabdomyolysis (rare)
  • toxic hepatitis
  • myalgia4
     

More information is available in the drug-drug interaction section.



Dyslipidemia may occur with or without metabolic syndrome, which in the general population is associated with an increased risk of cardiovascular events.1

  • According to the Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) metabolic syndrome includes three or more of the following conditions:
    • low HDL-c (high-density lipoprotein cholesterol; <1.03 mmol/L [<40 mg/dL] for men; <1.29 mmol/L [<50 mg/dL] for women.5
    • elevated triglycerides (≥1.69 mmol/L [≥150 mg/dL])
    • central obesity (waist circumference of ≥40 inches in men; ≥35 inches in women)
    • hypertension (blood pressure of ≥130/85 mmHg, or receiving treatment for hypertension)
    • high fasting blood sugar (≥6.11 mmol/L [≥110 mg/dL] or receiving treatment for high blood sugar).
       

References

  1. Tungsiripat M, Aberg JA. Dyslipidemia in HIV patientsCleve Clin J Med. 2005;72:1113–1120.
  2. Yadav D, Pitchumoni CS. Issues in hyperlipidemic pancreatitis. J Clin Gastroenterol. 2003;36(1):54-62.
  3. European AIDS Clinical Society (EACS). Guidelines. Version 6.0. Accessed 3 July 2012.
  4. Harper CR, Jacobson TA. The broad spectrum of statin myopathy: from myalgia to rhabdomyolysis. Curr Opin Lipidol. 2007;18(4):401-408.
  5. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497.