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. Regular exercise should be encouraged since this raises HDL and lowers weight and blood pressure. Hypertension should be aggressively treated. Before prescribing an anti-lipid drug, secondary causes of hyperlipidemia should be treated, and if the patient is taking a medication that could cause hyperlipidemia, consideration should be made to changing the drugs, if possible. Retest the lipid panel in 8 to 12 weeks after any therapeutic changes.