Hypercholesterolemia: Medical History

Medical history (history of illness) represents an important component in the diagnosis of hypercholesterolemia (pure LDL elevation).

Family history

  • Is there a frequent occurrence in your family
    • lipometabolic disorders?
      • Early atherosclerosis (arteriosclerosis, hardening of the arteries) in family history – women < 70 years, men < 65 years.
      • Hyperlipoproteinemia (dyslipidemia) in the family history.
    • Heart attacks?
    • Vascular diseases?
  • Are there any hereditary diseases in your family?

Social history

  • Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

  • Have you noticed any small yellowish-white skin lesions?

Vegetative anamnesis incl. nutritional anamnesis.

  • Are you overweight? Please tell us your body weight (in kg) and height (in cm).
  • Do you consume a lot of saturated fatty acids as well as cholesterol and trans fatty acids (e.g. bakery products, chips, fast food products, convenience foods, fried foods, breakfast cereals with added fat, French fries, snacks, sweets, dry soups) in your diet?
  • Are you pregnant?
  • Do you get enough exercise every day?
  • Do you smoke? If so, how many cigarettes, cigars or pipes per day?
  • Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
  • Do you use drugs? If yes, what drugs and how often per day or per week?

Self history incl. medication history.

Medication history

Drugs that increase LDL

  • Carbamazepine (antiepileptic) – drug used to treat epilepsy (seizures).
  • Ciclosporin (cyclosporin A) – drug for immunosuppression.
  • Thiazides (diuretic) – medication for drainage.

Drugs that increase VLDL

  • Anion exchangers – drugs used to lower fat (lipid inhibitors), such as colestyramine; these bind bile acids in the intestine and increase their excretion; the body compensates for this resulting deficiency and requires cholesterol to do so
  • Antiretroviral therapy (ART) – for example, HIV protease inhibitors; drug treatment strategy for HIV patients.
  • Glucocorticoids – belong to the corticosteroids, a class of steroid hormones from the adrenal cortex; naturally occurring glucocorticoids include cortisol and corticosterone.
  • Retinoic acid (derivative / derivative of vitamin A).

Drugs that increase chylomicrons.