Dyslipidemia: A Review of Pathophysiology and Lipoprotein Disorders

Introduction

Coronary heart disease (CHD) affects millions of patients around the world. In recent years 1.6 million hospital admissions were for acute coronary syndromes (ACS) in the United States alone.1 As more nations “Westernize” and their populations are exposed to increasing risk factors for coronary artery disease (CAD), this will be a substantial and perhaps the greatest international health concern in the next several decades.

Abstract

Coronary heart disease affects millions of patients around the world, and its prevalence makes understanding the variety of risk factors that contribute to coronary artery disease (CAD) paramount for any clinician. One important risk factor that has been identified is dyslipidemia and the spectrum of lipid disorders that this entails. The relationship between dyslipidemia and CAD is well established, and clinically it is important to understand the basic pathophysiology for disease prevention and treatment. Fats are essential to life and are metabolized and circulated in the body through the lipid transport system. Their storage, regulation, and processing are maintained in a fine balance, but with simple alterations can lead to profound consequences including heart attack, stroke, and peripheral vascular disease. An understanding of basic pathophysiology of lipids, their role in the body, and how disruption in their metabolism manifests into systemic disease is a vital part of caring for the ever increasing number of patients with dyslipidemia. Therapeutic approaches to clinical dyslipidemias are described in a prior review on the topic previously published in the Journal of Clinical Metabolism & Diabetes (April 2011 issue) as a companion to the present article.

Keywords

dyslipidemia, coronary heart disease, lipid transport system, lipoproteins, coronary artery disease, lipoprotein disorders