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2004, Número 1

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Rev Endocrinol Nutr 2004; 12 (1)


Diagnóstico y tratamiento de las dislipidemias: posición de la Sociedad Mexicana de Nutrición y Endocrinología

Aguilar SCA, Gómez PFJ, Lerman GI, Cuauhtémoc Vázquez Chávez, Óscar Pérez Méndez, Carlos Posadas Romero

Idioma: Español
Referencias bibliográficas: 54
Paginas: 7-41
Archivo PDF: 289.90 Kb.


RESUMEN

Este documento, avalado por la Sociedad Mexicana de Nutrición y Endocrinología, tiene por objeto presentar las recomendaciones de un grupo de autores, con experiencia en el campo, sobre el diagnóstico y tratamiento de las dislipidemias. La información se presenta en forma didáctica, utilizando esquemas de flujo para la toma de decisiones. Las recomendaciones se basan en datos obtenidos en población mexicana y en estudios controlados. Las recomendaciones más relevantes son: 1) el escrutinio de una dislipidemia es costo/efectivo en todo adulto mayor de 20 años, 2) el abordaje diagnóstico inicia al clasificar los casos por síndromes (hipercolesterolemia aislada, hipertrigliceridemia aislada, hiperlipidemia mixta e hipoalfalipoproteinemia), 3) el diagnóstico etiológico de la dislipidemia puede ser identificado en la mayoría de los casos, 4) la identificación de la etiología ayuda a la estimación del riesgo cardiovascular, 5) no recomienda el uso sistemático de las tablas de Framingham, 6) se identifican condiciones que requieren tratamiento prioritario de la dislipidemia; estos casos son candidatos para recibir tratamiento farmacológico, 7) los casos considerados como no prioritarios deben ser tratados con modificaciones del estilo de vida, 8) se recomiendan metas de tratamiento específicas para los casos prioritarios; no se recomienda el uso de metas estratificadas para el colesterol LDL, 9) las estatinas son los fármacos de primera elección en casos con hipercolesterolemia aislada; los fibratos lo son para la hipertrigliceridemia aislada. En conclusión, la corrección de la dislipidemia es uno de los componentes de cualquier programa de prevención de aterosclerosis; para alcanzar una prevención eficaz, todos los factores de riesgo deben ser detectados y tratados.


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