Vnitr Lek 2010, 56(6):526-531

Hyperlipoproteinaemia and dyslipoproteinaemia I. Classification, diagnostics, cardiovascular, cardiometabolic and residual risk

R. Češka^*, M. Kvasilová, R. Procházková, G. Šmelková, M. Vrablík

Centrum preventivní kardiologie III. interní kliniky 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA

Cardiovascular diseases remain the most important cause of death worldwide. The situation in the Czech Republic is one of the best when compared to the other countries of the former socialist block; on the other hand, we significantly lack behind when the comparison is made to south and southwest European countries. The concept of risk factors (RF) and multifactorial character of atherosclerosis as the main cause of cardiovascular diseases (CVD) is fully accepted at present. Hyperlipoproteinaemia (HLP) and dyslipidemia (DLP) are a group of high incidence metabolic diseases characterised by increased levels of lipids and lipoproteins in plasma or, in case of DLP, by unsuitable, atherogenic composition of lipids and lipoproteins in plasma. HLP and DLP are among the most important RF for the development of CVD. Mainly LDL-cholesterol (LDL-C) is perceived as a very important risk factor; successful reduction of LDL-C is linked to a reduction in cardiovascular risk. Even when LDL-C is decreased and the so-called "target values" achieved, patients are still at risk of a CV event. This remnant risk is the so called "residual risk". The most important "rival" to LDL-cholesterol among the risk factors is the metabolic syndrome, or rather the DLP associated with the metabolic syndrome, characterised from the perspective of DLP by low levels of HDL-cholesterol and increased triglycerides with concurrent occurrence of "small dense LDL". The issue of heterogeneity and atherogenicity of lipoprotein particles in general then becomes topical. Lipoprotein (a) - Lp(a) is another important lipid risk factor that is getting a significant attention.

Keywords: hypercholesterolaemia; LDL-cholesterol; metabolic syndrome; HDL-cholesterol; hypertriglyceridaemia; heterogeneity of lipoprotein particles; residual risk; Lp(a)

Received: May 19, 2010; Published: June 1, 2010  Show citation