Value of screening for secondary causes of hyperlipidaemia in general practice

The number of estimations of serum cholesterol concentrations being performed has risen dramatically in the past few years. The reason for the rise is partly that general practitioners are increasingly realising the importance of cholesterol and partly that authoritative reports - notably that of the Royal College of General Practitioners1 and the European Atherosclerosis Society2 - have encouraged general practitioners to screen for raised cholesterol concentrations. Leading lipidologists and all the major textbooks emphasise the association between a raised serum cholesterol concentration and diabetes, hypothyroidism, excessive alcohol consumption, and renal failure,3, 4 and virtually all authorities advise general practitioners to make sure that when hyperlipidaemia is present no treatable cause exists. All patients with hyperlipidaemia should therefore have at least …