Segment 1 Opening credits. Footage of unhealthy activities (e.g. walking alongside heavy traffic, smoking, fatty food) and related medical images (e.g. taking blood pressure, measuring body fat) is seen. Dr Thompson introduces the topic of hyperlipoproteinaemia, saying that he prefers this term 'on conceptual grounds' to hyperlipidaemia (elevated lipids in the blood). He discusses the factors involved in the pathogenesis of atheroma and in atherogenesis. Diagrams of the arterial wall, components of the blood and the haemodynamic forces acting within the arterial lumen are seen. Thompson explains that this lecture will focus on the rold of the components on the blood, in particular the plasma lipids. He discusses a study undertaken in Aberdeen on the cholesterol content of arteriole tissue taken at autopsy. The results of this study are shown in charts. Thompson also mentions other studies on this topic showing that between 30 and 60% of patients with ischaemic heart disease have either a raised serum cholesterol or triglyceride or both. He next discusses lipoproteins, shown in photomicrographs. He explains their composition. Time start: 00:00:00:00 Time end: 00:04:53:00 Length: 00:04:53:00
Segment 2 Thompson examines the relationship between lipoproteins and atheroma, referring to a Russian study of arteriole tissue. A diagram of the procedure used is seen. Thompson discusses the result of this experiment, which found elevated levels of lipoproteins in fatty aortae. He next discusses the methods used to quantitate lipoproteins, going through the five stages and using diagrams to explain the process. He gives figures for ideal cholesterol levels for healthy adults. Time start: 00:04:53:00 Time end: 00:10:08:00 Length: 00:05:15:00
Segment 3 Thompson discusses the various classifications of hyperlipoproteinaemia and discusses the patterns of each. He goes on to discuss the frequency of these types in ischaemic heart disease. The frequencies are shown in a chart. Next, he considers the clinical features of the types of hyperlipoproteinaemia, discussing each in turn. He also explains the symptoms of patients suffering from each type. Time start: 00:10:08:00 Time end: 00:14:54:00 Length: 00:04:46:00
Segment 4 Thompson continues to explain the clinical features of each type of hyperlipoproteinaemia. Photographs and x-rays of typical features (arcus, xanthomata and palmar striae) of atheroma in male and female patients are seen. Diagrams describing the clinical features are also seen. He also mentions that patients with type IV pattern are often obese. Time start: 00:14:54:00 Time end: 00:20:17:00 Length: 00:05:23:00
Segment 5 Thompson passes over to Dr Barry Lewis, who discusses the secondary hyperlipidaemic states. He discusses the number of patients with secondary hyperlipidaemias at the Hammersmith Lipid Clinic as well as treatment. He also describes testing for secondary hyperlipidaemias. He then talks about secondary hypercholesterolaemias and describes the symptoms. He describes rare causes of secondary hypercholesterolaemia, including acute porphyria and various dysglobulinaemias. Time start: 00:20:17:00 Time end: 00:25:13:14 Length: 00:04:56:14
Segment 6 Lewis describes other causes of secondary hypercholesterolaemia, including exposure to certain halogenated insecticides and Turner's syndrome. He then turns to the causes of secondary hypertriglyceridaemia, usually a combination of a genetic hypertriglyceridaemic state and an environmental factor such as alcoholism. The four common causes of secondary hypertriglyceridaemia are listed, including uncontrolled diabetes, alcoholism, chronic renal disease and hypothyroidism. He goes on to discuss rare forms of hypertriglyceridaemia of known aetiology. He describes the association of gout with ischaemic heart disease. Time start: 00:25:13:14 Time end: 00:30:06:13 Length: 00:04:52:24
Segment 7 Lewis then discusses disorders of the pituitary gland; patients with these conditions frequently show moderate hypertriglyceridaemia. He also talks about chronic liver disease, viral hepatitis, cirrhosis and exposure to exogenous oestrogens, which may produce hypertriglyceridaemia and sometimes hypercholesterolaemia. Further causes include Cushing's syndrome and Addison's disease. He then talks about glycogen storage disease, a common cause of hypertriglyceridaemia in the neonate. He passes back to Dr Thompson, who discusses some advances in the field of primary hyperlipoproteinaemias. This concludes the lecture. End credits. Time start: 00:30:06:13 Time end: 00:34:50:01 Length: 00:04:43:13