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Ken Sakaris

34 year old man, family history
of heart disease…
cholesterol: High
triglycerides: High
all else: Normal
What type of LDL?
-small, dense
“Has lots of LDL; lots of it is
small & dense”

In familial hypercholesterolemia…
LDL that accumulates most:
small, dense particles
It is a disease of
If triglycerides above 1.2
-in hypercholesterolemia
will have small, dense LDL

1.2 mmol/L = 21.6 mg/dL

Normal patient: statin?
-no benefit
Diabetic patient: statin?
-3% benefit
In familial hypercholesterolemia…
-80% benefit!
small, dense LDL
more than just making
general LDL disappear

How to know if you have it?
cholesterol above 9.3
means you have it

9.3 mmol/L = 168 mg/dL

Case: 41 y.o. man with
heart palpitations…
-cholesterol 15 [270 mg/dL] BUT
-4 months ago: 4 [72 mg/dL] specialists do not know why
“This is the hyper-responder
to low carb/high fat diet”
he: small, dense LDL?
His LDL must be very low
to prevent small, dense rise


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