President's Column

Roger S. Blumenthal, MD. FACC, FAHA
Associate Professor of Medicine
Director, The Johns Hopkins Ciccarone Center for the
Prevention of Heart Disease

It is an honor for me to be this year's president of the Southeast Lipid Association. I am especially pleased to follow in the footsteps of my friend, colleague, and mentor Dr. Diane Becker, who was very instrumental in convincing me to pursue an academic career at Johns Hopkins. This is an exciting time for those of us interested in dyslipidemia management. Data from 5 new clinical trials since the 2001 release of the ATP III guidelines prompted the NCEP to publish an implications paper in July 2004. It concluded that there was indeed additional clinical benefit to lower LDL-cholesterol (LDL-C) and non-HDL-C in high risk patients even when the baseline LDL-C was below 100 mg/dl.

I joined the Hopkins faculty in 1992 and many of my colleagues were cholesterol skeptics. Now the vast majority of cardiologists, endocrinologists, gynecologists, internists, and other primary care providers understand the importance of treating elevated lipids. Several ongoing trials will tell us with more assurance about how low we should go in terms of LDL-C and non-HDL-C.

We clearly need more data about the optimal treatment of adults with low HDL-C and/or high triglyceride levels. We also need to learn more about the apparent non-lipid benefits of statins, fibrates, niacin, and the cholesterol absorption inhibitors. Peroxisome proliferator-activated receptor agonists may also have direct anti-inflammatory effects at the transcriptional level.

The Center for Science in the Public Interest points out that there is less evidence of benefit in the primary prevention settings for women and the elderly. Nevertheless, the line separating primary and secondary prevention is blurred due to techniques such as EBCT and carotid ultrasound, which show that most adults over age 55 have significant subclinical atherosclerosis. We also need to realize that dyslipidemia is often the result of suboptimal dietary and exercise habits. Many adolescents and adults have the metabolic syndrome and we need to promote better lifestyle changes. Clearly physicians, nurses, dietitians, and exercise physiologists need to work together to optimally treat dyslipidemia and to markedly delay the onset of cardiovascular disease.

As an avid golfer, I am very pleased that our annual scientific meeting will be at Pinehurst, the site of the 2005 U.S. Men's Golf Open and where the late Payne Steward won his last title. I hope that many of you will bring your golf clubs and encourage your friends who are golfers to attend this year's meeting. Dan Wise and Dean Bramlett did a fabulous job on last year's program and we anticipate that we will have another superb program. Thank you all for your interest in SELA and the National Lipid Association.