Which specialist consultations are beneficial to patients with low HDL cholesterol (hypoalphalipoproteinemia)?

Updated: May 21, 2021
  • Author: Vibhuti N Singh, MD, MPH, FACC, FSCAI; Chief Editor: George T Griffing, MD  more...
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Answer

Always consider secondary causes of low HDL levels, especially medications, smoking habits, dietary patterns, and physical activity. Patients with elevated triglyceride levels (>500 mg/dL) commonly have low HDL cholesterol levels; address hypertriglyceridemia first in such patients. Patients with moderately reduced HDL levels (20-35 mg/dL) usually have secondary causes that should be addressed. Individuals with severely reduced HDL levels (< 20 mg/dL) may have a specific genetic etiology, such as familial lecithin-cholesterol acetyltransferase (LCAT) deficiency, Tangier disease, or mutations in apo A-I. Ironically, these disorders are not commonly associated with an increased risk of atherosclerosis. Refer patients who may possibly have one of these diagnoses to a specialized lipid center for advanced management. Consultation with the following specialists may be required:

  • Lipidologist

  • Endocrinologist

  • Cardiologist

  • Vascular specialist

  • Cardiovascular surgeon

  • Dietitian


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