What are the diagnostic criteria for hyperlipidemia in the United Kingdom (UK)?

From the Guidelines

Hyperlipidemia in the UK is diagnosed based on blood lipid levels, with specific thresholds considered elevated, as outlined in the Joint British Societies' recommendations 1. The diagnostic criteria for hyperlipidemia in the UK consider total cholesterol, HDL cholesterol, and other lipid profiles.

• The Joint British Societies provide a table outlining the relationship between serum cholesterol and HDL cholesterol levels 1.
• Total cholesterol levels are categorized, with corresponding HDL cholesterol values, to determine the risk of coronary heart disease.
• For example, a serum cholesterol level of 12 mmol/L corresponds to an HDL cholesterol level of 0 mmol/L, while a serum cholesterol level of 7 mmol/L corresponds to an HDL cholesterol level of 2.5 mmol/L 1.
• Other studies, such as those published in the Journal of the American College of Cardiology 1 and the Proceedings of the Nutrition Society 1, provide additional guidance on lipid management and cardiovascular risk assessment.
• However, the most relevant and recent guidance for diagnosing hyperlipidemia in the UK is provided by the Joint British Societies' recommendations 1.
• The diagnosis of hyperlipidemia in the UK should be based on the Joint British Societies' guidelines, which consider both lipid levels and cardiovascular risk factors 1.
• Risk assessment is crucial, with treatment thresholds varying based on cardiovascular risk factors, such as age, family history, and presence of other conditions like diabetes or hypertension.
• The diagnosis considers both absolute lipid values and the patient's overall cardiovascular risk profile, with treatment decisions based on this comprehensive assessment rather than isolated lipid values alone.

From the Research

Diagnostic Criteria for Hyperlipidemia in the UK

The diagnostic criteria for hyperlipidemia in the UK are not explicitly stated in the provided studies. However, the studies provide information on the management and treatment of hyperlipidemia.

Management and Treatment of Hyperlipidemia

• The study by 2 discusses the guidelines for cholesterol-lowering medication in the UK, USA, and Europe, which either advocate for fixed dose statin treatment without low-density lipoprotein (LDL) cholesterol targets or treatment aimed at LDL cholesterol goals.
• The study by 3 provides an overview of current and novel treatments for dyslipidemia, including pharmacological agents and nutritional supplementation.
• The management of dyslipidemia involves the use of various classes of drugs and treatments, including 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, selective cholesterol absorption inhibitors, and proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) 3.
• The study by 2 suggests that aiming for LDL cholesterol targets with statin dose titration (and when necessary adjunctive medication) is essential to optimize benefit in hypercholesterolaemia.

LDL Cholesterol Levels and Cardiovascular Disease Risk

• The study by 2 found that reductions in LDL cholesterol concentration are determined by the choice and dose of medication and by the pre-treatment LDL cholesterol concentration.
• At similar cardiovascular disease (CVD) risk, people with higher pre-treatment LDL cholesterol benefit more from treatment than those with lower levels 2.
• The study by 2 also found that fixed dose statin regimens are less effective than target LDL cholesterol levels of 1.8 or 1.4 mmol/l when pre-treatment LDL-cholesterol levels exceed 4 mmol/l.