Fall 2012 LipidSpin Articles | National Lipid Association Online

Peter P. Toth, MD, PhD, FNLA	From the NLA President: An Exciting but Challenging Time It is my privilege to serve as President of the NLA during this coming year. As is always the case, this is both an exciting but also a very challenging time. I would like to tell you about some of the programs and initiatives we are rolling out this year. In September, we are convening a panel of 13 experts in Charlotte who will generate a consensus statement on Adiposity and Dyslipidemia. The panel will address issues of pathophysiology as well as assess the role/impact of... more
PERRY J. WEINSTOCK, MD, FACC, FNLA	From the NELA President: Lipid Spin: A Collaborative Effort It is my great honor to serve as President of the Northeast Lipid Association (NELA). One of the responsibilities of the President is to choose the topics and invite the authors for Lipid Spin. Accordingly, this edition of Lipid Spin was developed with my suggestions and direct input. I must say that the task, though daunting at first, was made a true labor of love with the help of all the great chapter members who eagerly participated and with the constant support of the... more
ROBERT A. WILD, MD, PhD, MPH, FNLA	Editor’s Corner: Practicing Based on Evidence One of the NLA's missions is to move our educational efforts towards practicing based on best evidence. You will be seeing segments of Lipid Spin dedicated to this objective. There are many interesting aspects of lipidology addressed and displayed in a multi-disciplinary fashion in this edition of Lipid Spin. Thanks to Perry Weinstock, MD, as he assembled many contributors for each of us to learn from. There are many types of articles presented in this... more
Robert S. Rosenson, MD, FNLA	Clinical Feature: HDL and Cardiovascular Disease Risk—Risk Marker or Risk Factor? Low HDL cholesterol (HDL-C) is an established biomarker for the future development of atherosclerosis and atherosclerotic cardiovascular disease (CVD) events in population-based observational studies and clinical trials of cholesterol-lowering therapies and this includes coronary heart disease (CHD) patients with low levels of LDL cholesterol (LDL-C) on statin therapy.^1-3Because multiple clinical trials designed to increase HDL-C and reduce CVD risk have not demonstrated efficacy... more
SPENCER D. KROLL, MD, PhD	EBM Tools for Practice: Risk Reductions Clinicians are constantly presented with data and results intended to influence the treatment they render to patients. However, in spite of the gravity of the consequences of treatment, we are often not supplied with appropriate and adequate data on which to base our judgment of effectiveness. Such situations become clearer when we see media reports with "relative risk reduction" in treatments rather than statistics on "absolute risk reduction." The difference in data... more
KENNETH A. KELLICK, PharmD, CLS, FNLA	Specialty Corner: Coping with Statin Adverse Events—Focus on Pharmacokinetics and Pharmacodynamics We all see patients in our practice who either have complaints of muscle aches after starting HMG-Co-A Redtucase inhibitors (statins) or have been referred by other health care practitioners for management of dyslipidemia in the presence of suggested diagnosis of statin myopathy. A careful differential diagnosis should take into account many factors: ... more
VANESSA L. MILNE, MS, NP, CLS	Practical Pearls: Primary Hypertriglyceridemia—Treating Triglycerides When It’s Not the Usual Suspects Hypertriglyceridemia (HTG) is defined as an excess of triglycerides in the blood. Primary HTG is caused by one or more genetic defects leading to triglyceride elevation. Secondary HTG is acquired; the causes are plethoric and can be identified by methodically assessing the factors listed in Table 1. Primary HTG should be suspected if a secondary cause cannot be identified. In addition, an astute clinician should consider primary HTG when the patient with a secondary cause has a fasting... more
Merle Myerson, MD, EdD, FACC	Case Study I: The Patient with Family History of Premature Coronary Heart Disease Patient LH, a 39-year-old white male came to me for evaluation as he was concerned about his risk for coronary heart disease (CHD). His father had coronary artery disease at age 46. He had 99% blockage of his right coronary artery and subsequent stent placement. While not first degree relatives, he also has several aunts, uncles, and cousins with early coronary heart disease (defined as women prior to age 55 and women prior to age 65). On his first visit he stated that he felt very... more
Samuel S. Gidding, MD	Lipid Luminations: The Controversy Over Universal Cholesterol Screening for Children In 2011, the NLA and the National Heart Lung and Blood Institute (NHLBI) sponsored expert panel on Integrated Cardiovascular Risk Reduction for Children and Adolescents each recommended universal lipid screening of United States children at age 9-11 years.^1,2 Prior reports recommended cholesterol measurement over age 2 years in the presence of a positive family history of heart disease or elevated cholesterol or the presence of a co-morbid condition known to increase... more
Danielle Duffy, MD, FACC Edward Goldenberg, MD, FACC, FACP, FNLA	Case Study II Does Gender Matter in Cardiovascular Risk Assessment? JR is a 69-year-old white female with longstanding, well-controlled hypertension treated with an ACE-inhibitor who comes in for a cardiovascular risk evaluation. She denies a personal history of diabetes, tobacco abuse, psoriasis, collagen vascular disease, or chronic kidney disease. There is no family history of premature vascular disease. She is moderately active and has no clinical symptoms referable to the cardiovascular system. Her medications also include anti-depressants and... more
SUNEET VERMA, MD, FACP, FNLA	Member Spotlight: Suneet Verma, MD When he moved to South Dakota to fulfill a rural medicine requirement, Suneet Verma, MD, never guessed he would become fascinated with lipids. A native of Delhi, India, Dr. Verma came to the United States to do his post-graduate training in internal medicine at the University of Pittsburgh Medical Center. In South Dakota, he worked as an internist at Avera McKennan University Hospital and also as a Clinical Associate Professor of Medicine at the University of South Dakota School of Medicine... more
ANNE C. GOLDBERG, MD, FNLA	Foundation Update First, I would like to thank everyone who supported the NLA’s 10th Anniversary President’s Gala, which raised almost $10,000 for the Foundation and was our largest fundraiser to-date. More than 200 NLA members and guests attended the gala during the Annual Scientific Sessions this past May in Scottsdale, Arizona, where entertainment was provided by Alan Brown, MD, and his band This End Up. We had a great time supporting a tremendous organization and I thank all... more
Daniel J. Rader, MD, FNLA EMIL M. deGOMA, MD	Guest Editorial: HDL-targeted Therapies—Where Do We Go From Here? A recent succession of negative studies— including two randomized, placebocontrolled intervention trials^{1, 2}and a large genetic association analysis3—calls for a careful re-examination of the approach to HDL-directed therapies. In May 2011 the Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health (AIM-HIGH) trial was stopped early due to futility.4 In the setting of mildly reduced HDL-C levels (mean baseline 35 mg... more