Assessing and managing hyperlipidemia

Because more than one-half of adult Americans have total blood cholesterol levels that often contribute to atherosclerotic blockage of their coronary arteries, routine random screening of all adults and high-risk children for hypercholesterolemia is recommended. Reduced intake of saturated fat and cholesterol can lower total and low-density lipoprotein (LDL) cholesterol by 10-20 percent, while several medications lower total and LDL cholesterol by 15-40 percent. A highly effective cholesterol-lowering medication, lovastatin, has been recently marketed. The efficacy and long-term safety of ingesting large amounts of omega-3 fatty acids in fish oil supplements are unproven. Hypercholesterolemia is a family problem transmitted between generations by various combinations of genetic factors and learned behaviors. The family physician can be most effective by working with entire families to detect and treat hypercholesterolemia early in life to prevent serious consequences of prolonged cholesterol elevation.