Dyslipidemia in Special Populations

**45**

ethnic groups.

**Chapter 3**

**Abstract**

**1. Introduction**

*and Clinton D. Brown*

lism may explain this racial/ethnic difference.

the ACC/AHA cholesterol guidelines [1].

Dyslipidemia in Special

Populations, the Elderly, Women,

HIV, Chronic Kidney Disease and

This chapter discusses the management of dyslipidemia in special patient populations: the elderly, woman and pregnancy, renal disease, human immunodeficiency virus (HIV), and different racial/ethnic groups. In the elderly, dyslipidemia is often underdiagnosed and undertreated. Consideration for potential atherosclerotic risk-reduction benefits, risk of adverse effects, drug-drug interactions, and patient preferences should precede the initiation of statin therapy. Data on pregnant women are lacking and need future research. Dyslipidemia and its effects on the cardiovascular system in chronic kidney disease (CKD), end-stage renal disease (ESRD), and HIV are dynamic and multimodal. These conditions are states of chronic inflammation, where it is difficult to associate quantities of cholesterol types with outcomes. Among all racial groups, Asian Indians, Filipinos, and

Hispanics are at a higher risk for dyslipidemia. Genetic differences in statin metabo-

Dyslipidemia, defined as high levels of low-density lipoprotein cholesterol (LDL-C) (≥130 mg/dl), total cholesterol (≥200 mg/dl), and triglycerides (TG) (≥150 mg/dl), or low levels of high-density lipoprotein cholesterol (HDL-C) [<40 (men) and < 50 (women) mg/dl], is a major risk factor for cardiovascular disease (CVD). Significant heterogeneity in patterns of dyslipidemia exists in these special populations. There is confusion among health-care providers regarding selection and implementation of appropriate guidelines, particularly for special patient populations. Patients in special populations may not clearly fall into one of the four statin-benefit groups identified by

In this chapter, we review the evidence in patterns of dyslipidemia and management in the elderly, women and pregnancy, CKD, ESRD, HIV, and different racial/

**Keywords:** dyslipidemia, elderly, women, racial disparity, gender disparity

ESRD, and Minority Groups

*Amarpali Brar, Jeans M. Santana, Moro O. Salifu* 

**Chapter 3**
