1. Hyperlipidemia
John Baer

2. What is it?
Hyperlipidemia- any condition that elevates fasting blood triglyceride and cholesterol concentrations
Dyslipidemia- altered blood lipid and lipoprotein concentrations
Hypercholesterolemia- elevated cholesterol
Hypertriglyceridemia- elevated triglycerides
Hyperlipoproteinemia- elevated lipoproteins
Hypoalphalipoprotein syndrome- low HDL
Postprandial lipemia- postprandial rise in TG rich proteins after eating

3. Understanding

4. Epidemiology On the decline
Average cholesterol went from 213 mg/dl to 203 mg/dl ( )
17% of adults have cholesterol 240 mg/dl or greater
67.6% had blood checked in 1991
73.1% had blood checked in 2003
Greater awareness

5. Symptoms Cholesterol greater than 240 mg/dl LDL often over 260 mg/dl
HDL lower than 40 mg/dl

6. Testing
Obtained through complete blood lipid profile from forearm venipuncture following a 12 hour fast
Finds total cholesterol, LDL-C, HDL-C, and triglycerides.

7. Complications Dyslipidemia itself is not a complication
Patients with dyslipidemia may also have other diseases or disabilities which may prevent them from exercise
A thorough medical review must be conducted before any exercise training

8. Treatment
Lifestyle changes
Medications

9. Lifestyle Changes TLC diet, therapeutic lifestyle changes
Fat intake 25-35% total calories
Saturated fat less than 7%, polyunsaturated fat 10%, and monounsaturated fat 20% of calories
Increases in dietary fiber and plant stanols or sterols
Encouraged to eat more fruits, vegetables, and high fiber foods

10. Lifestyle Changes cont.
Smoking cessation
Exercise

11. Medications
If lifestyle changes are not working well enough for 6 months medications used
Statin agents are most commonly used
Increase HDL and decreases LDL
Inhibits cholesterol synthesis

13. Effects of Disease on Exercise
Dyslipidemia alone does not affect exercise
Cardiovascular disease could cause angina
Medications currently taking

14. Medications on Exercise
P. 43 Clinical Exercise Physiology

15. Effects of Exercise on Disease
Lower triglyceride concentrations
Reduced postprandial lipemia
Decreased concentrations of LDL
Higher HDL concentrations
Increases in lipoprotein enzyme activity
Improved glycemic control
Reduction in adiposity indirectly lowers blood lipid concentrations
P. 225 Pollock’s

16. Exercise Testing Follow protocols for populations at risk for CAD
Diagnose CAD
Determine functional capacity
Determine appropriate intensity range for aerobic exercise training
High cholesterol may cause ischemia

17. Exercise Programming Aerobic exercise is the foundation of the program
Exercise at 40-80% VO2 max
5 or more days per week
Once, maybe twice per day
Incorporate resistance training in program
45 minutes per session
P. 172 ACSM

18. Conclusions Have blood lipids checked every 1-5 years
Could prevent CAD and atherosclerosis
Eat healthy and exercise

19. References
Know the Risks: Lifestyle Management of Dyslipidemia by Paul Sorace, Thomas LaFontaine, and Tom R. Thomas
ACSM’s Exercise Management for Persons With Chronic Diseases and Disabilities by J. Larry Durstine, Geoffrey E. Moore, Patricia L. Painter, Scott O. Roberts
Clinical Exercise Physiology 2nd Edition by Jonathan K. Ehrman, Paul M. Gordon, Paul S. Visisch, Steven J. Keteyian
Pollock’s Textbook of Cardiovascular Disease and Rehabilitation by J. Larry Durstine, Geoffrey E. Moore, Michael J. LaMonte, Barry A. Franklin
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