```xml
<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<ns4:query_definition xmlns:ns2="http://www.i2b2.org/xsd/cell/crc/psm/1.1/" xmlns:ns4="http://www.i2b2.org/xsd/cell/crc/psm/querydefinition/1.1/" xmlns:ns3="http://www.i2b2.org/xsd/cell/crc/psm/analysisdefinition/1.1/">
    <query_name>Hyp-Met-Cho-Ant@18:33:48</query_name>
    <query_timing>ANY</query_timing>
    <specificity_scale>0</specificity_scale>
    <panel>
        <panel_number>1</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>0</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>2</hlevel>
            <item_name>Hypertensive diseases (i10-i15)</item_name>
            <item_key>\\ICD10_ICD9\Diagnoses\(I00-I99) Dise~3w8h\(I10-I15) Hype~5igm\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>Diagnoses \ Diseases of the circulatory system (i00-i99) \ Hypertensive diseases (i10-i15)</tooltip>
            <class>ENC</class>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
    <panel>
        <panel_number>2</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>0</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>2</hlevel>
            <item_name>Metabolic disorders (e70-e88)</item_name>
            <item_key>\\ICD10_ICD9\Diagnoses\(E00-E89) Endo~c157\(E70-E88) Meta~6ibb\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>Diagnoses \ Endocrine, nutritional and metabolic diseases (e00-e89) \ Metabolic disorders (e70-e88)</tooltip>
            <class>ENC</class>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
    <panel>
        <panel_number>3</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>0</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>4</hlevel>
            <item_name>Cholesterol (Group:CHOL)</item_name>
            <item_key>\\i2b2_LABS\i2b2\Labtests\LAB\(LLB16) Chemistry\(LLB17) Lipid Tests\CHOL\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>Labtests \ Chemistry \ Lipid Tests \ Cholesterol (Group:CHOL)</tooltip>
            <class>ENC</class>
            <constrain_by_value>
                <value_operator>GT</value_operator>
                <value_constraint>200</value_constraint>
                <value_unit_of_measure>mg/dl</value_unit_of_measure>
                <value_type>NUMBER</value_type>
            </constrain_by_value>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
    <panel>
        <panel_number>4</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>1</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>2</hlevel>
            <item_name>Antihyperlipidemic agents</item_name>
            <item_key>\\i2b2_MEDS\i2b2\Medications\MUL\(LME5) antihyperlipidemic agents\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>medications \ antihyperlipidemic agents</tooltip>
            <class>ENC</class>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
</ns4:query_definition>

```

I want to find patients with a diagnosis of hypertensive diseases (ICD10-ICD9 codes i10-i15), metabolic disorders (ICD10-ICD9 codes e70-e8), and who have had a cholesterol level greater than 200 mg/dl (based on the lab test CHOL), excluding those who have taken antihyperlipidemic agents (medications classified under LME5). The query will search for these conditions at any time in the patient's medical history with a high level of specificity.