General Information
An outpatient clinic for investigation and management of
patients with lipid disorders is run by consultants in Clinical
Biochemistry.
Additional information on risk charts and other
dietary guidance is available.
Referrals may be made directly to:
Dr Graham Bayly,
Lipid Clinic,
Department of Clinical Biochemistry,
Bristol Royal Infirmary.
Patients will be assessed for cardiovascular risk, and advised
on optimum diet, lifestyle and drug treatment to achieve target
lipid levels where possible. The department has access to a full
diagnostic service including genetic testing for lipid disorders
where appropriate. Advice is provided on family screening. Current
practice, in line with NHS and local trust policies, is that
patients will be assessed, have their treatment optimised, and then
be transferred back to primary care for follow-up. Telephone or
written advice is also available and may avoid the need for
patients to attend an outpatient appointment.
Requests for advice are welcome by letter, email (graham.bayly@UHBristol.nhs.uk)
or telephone (0117 342 3245). Please specify whether referral
is for appointment or for advice only.
Specific indications for referral/advice include the
following:
- Patients having a cardiovascular event on lipid lowering
treatment
- Patients with familial hypercholesterolaemia
- Patients at high cardiovascular risk unable to take statins
because of side effects or unable to achieve treatment targets
- Patients suspected of having a genetic hyperlpidaemia.
Indications include total cholesterol >8 mmol/L (once secondary
causes have been excluded), and/or family history of premature CHD
or hyperlipidaemia in a first degree relative.
- Patients with fasting triglycerides >5 mmol/L
- Patients with HDL cholesterol <0.9 mmol/L
- Homozygous familial hypercholesterolaemia
Specialist services
Paediatric Clinic
A joint clinic for children with familial hypercholesterolaemia
and other lipid and metabolic disorders is also run with Dr Julian
Shield at Bristol Royal Hospital for Children (BRCH). Referrals may
be made directly to Dr Bayly or to Dr Shield at BRCH
LDL Apheresis
The Lipid clinic provides a regional service for LDL-Apheresis
for the very few patients who require it. Referrals are welcome
from the South West region. Exception funding for this treatment is
required and will be sought for suitable patients following
assessment in the clinic. Current indications are:
Heterozygous familial hypercholesterolaemia, vascular disease, and
LDL cholesterol > 4 mmol/l despite maximal medical treatment and
good diet.
