Total cholesterol should be measured every 5 years. This information is important for therapeutic decisions. Additionally, secondary and potentially correctable causes of hyperlipidemia should be sought including diabetes mellitus, hypothyroidism, renal failure, nephrotic syndrome, alcohol abuse, and liver disease. Examine the eyes for findings of diabetes or hypertension. Therapy is goal-directed.
Numerous references are available to guide both the physician and patient.
Emphasize that diet, not medication, is the mainstay of therapy, requiring a permanent lifestyle modification. Sensitive, but persistent, work with the supply officer can help lower dietary fat and cholesterol not only for an individual patient, but also for the whole crew. The services of a registered dietitian, where available, prove invaluable. Treatment also involves risk factor reduction. Smoking must cease.