Prevention of Lipedema
An elevated LDL-C, a low HDL-C, and/or high triglycerides each require treatment with statins to prevent the lipid-related risks of cardiovascular disease. Along with statins, other risks, individually, should be addressed to reduce the global risk of heart disease.
- Education: Important so that the patient can partner with the treating physician to identify a treatment goal and the health benefits that come with reaching it.
- Nutritional counseling: Provides a strategic yet reasonable plan for caloric reduction and a shift in diet to favorably impact lipid levels, obesity and the metabolic syndrome, hypertension, and poor glycemic control.
- Smoking cessation: Counseling and possibly medication (smoking cessation aid) to assist in smoking cessation.
- Exercise: interacting with diet, they are both mutually important and interrelated. Physical exercise is also important in cognition, which improves motivation for the other risk reduction factors.
- Blood pressure control: Medications (antihypertensives) are used if diet and exercise do not reduce an elevated blood pressure.
- Good glycemic control: Diabetics already understand hyperglycemia and its toxic effects on the heart and cardiovascular system, but those with “pre-diabetes” should be counseled how diabetic risk overshadows all of the other risks.
Prevention of Statin-Induced Myopathy
Statins affect the synthesis of coenzyme Q10 (ubiquinone), which is an important part of muscle cell energy production. Because of this, rare cases of muscle injury can occur:
- Myalgia: Muscle pain and soreness
- Myopathy: Muscle weakness
- Myositis: Muscle inflammation
- Myonecrosis: Elevations of enzyme markers (CK) of muscle injury
- Rhabdomyolysis: When myoglobin from myonecrosis is excreted into the urine with or without renal failure
Myopathy can be prevented by judicious choice of which statin is prescribed, based on patient medical history, academic studies, other drugs being used by the patient, and dose adjustments. Other strategies include alternate-day dosing or merely switching statins.
Prevention of the dyslipidemia that calls for lipid-lowering medicines can be challenging, since it often is a genetic disease, but education, counseling, increased activity and weight management will cluster into a highly beneficial risk reduction/prevention program.