Winter 2016 LipidSpin Articles | National Lipid Association Online

Joyce L. Ross, MSN, CRNP, FPCNA, FNLA	From the NLA President: Dedicated Professionals Moving Forward It has been a very busy time at the National Lipid Association (NLA) and within our NLA chapters. We continue to move forward with integrating our work with other like-minded organizations. We were pleased to welcome a presentation on genetic counseling to help our members understand what can be expected, and potential benefits from a genetic consult at the Fall Clinical Lipid Update in late August in Amelia Island, Fla. The meeting provided an exciting opportunity for members to gather... more
Daniel A. Duprez, MD, PhD, FNLA	From the MWLA President: Guidelines, Evidence-Based, Precision, Personalized Medicine: Facing the Challenge in the Elderly I am honored and humbled to be serving as president of the Midwest Lipid Association (MWLA). The Midwest Chapter did a tremendous job preparing for this edition of the LipidSpin, which focuses on lipids and aging. The contributions from our NLA colleagues within the Midwest Chapter are outstanding, and this promises to be an excellent issue. The elderly population is at a high risk to develop cardiovascular disease events. The guidelines to treat hypercholesterolemia are derived from... more
Joseph J. Saseen, PharmD, BCPS, BCACP, FNLA	From the LipidSpin Editor: Medication Costs a Concern, Especially in Older Patients I love the theme of this edition of the LipidSpin, Lipids & Aging. When you read through the various articles, you will find outstanding discussions regarding the many aspects of treating older patients. Whenever I treat older patients with dyslipidemia, I always start by considering the overall risks versus benefits of statin therapy. Then I proceed to other aspects and considerations of providing patient-centered care. One aspect that is considered by many is the potential for “... more
Sarah J. Hallberg, DO, MS	Clinical Feature: Risk Factors and Lifestyle Considerations in Older Adults You can’t miss it. At the mall, at the gym, in your office, the percentage of older Americans is growing. By the year 2020 there will be more than 55 million Americans older than 65.1 Medically, we know not to treat kids just like “little adults” and we should have this same respect for differences in the management of older adults. This should apply to both our pharmaceutical and nutritional recommendations. Age is the single biggest risk factor for cardiovascular disease (CVD) and... more
Philip J. Barter, MBBS, PhD, FRACP	Guest Editorial: The Use of Statins to Reduce Cardiovascular Risk in the Elderly Introduction Human population studies have identified a number of major risk factors for the development of atherosclerotic cardiovascular disease (ASCVD). Of these, age is one of the more powerful. Another is the plasma concentration of low-density lipoprotein cholesterol (LDL-C). There is compelling and consistent evidence from clinical outcome trials that reducing the level of LDL-C with statins reduces the risk of having an ASCVD event. However, since most of the... more
Carl E. Orringer, MD, FNLA	Rebuttal: Statin Therapy for All Older Patients: A Word of Caution Dr. Barter’s perspective in the accompanying editorial is summarized in the last sentence of his article: “Given these facts, it is difficult to argue against the proposition that, unless contraindicated, all people older than 65 should receive a statin, regardless of the presence or absence of risk factors other than older age. Such action has the potential to substantially reduce morbidity in the elderly.” There is general recognition that advancing age is associated with increased... more
KAYE-EILEEN WILLARD, MD, FNLA	Lipid Luminations: From Microbes to Foam Cells Atherosclerosis is a lipid-driven disorder and the main underlying cause of cardiovascular disease (CVD).1 Microbiology has long been a critical focal area of medicine in terms of the effect of bacterial organisms on health and disease. What is the contemporary view of the relationship between these two aspects of clinical medicine? The role of the intestinal microbiome in the production of bioactive compounds derived from nutrient metabolism represents a previously neglected... more
SEAN D. STEWART, PharmD, BCACP, FNLA	Specialty Corner: Age-Related Pharmacokinetic Changes and the Impact on Statin Therapy in Older Patients While there is evidence for atherosclerotic cardiovascular risk reduction with statins in both primary and secondary prevention in older patients, there is a higher incidence of associated muscle symptoms and discontinuation because of those symptoms.1-3 Thus, consideration of the risk-benefit ratio of statins in older patients is recommended.4 Conventionally, the phrase “older patients” has been defined most frequently as a chronological age of 65 years and older. Older patients... more
JOHN P. STEIN, MD	Practical Pearls: My Statin or My Sarcolemma? Could Vitamin D Provide Some Answers for Improved Statin Compliance? Most coronary heart disease occurs in those over the age of 65.1 Statins reduce cardiovascular morbidity and mortality in both primary and secondary prevention. Data from the Cholesterol and Recurrent Events (CARE),2 Long-term Intervention with Pravastatin in Ischemic Disease (LIPID),3 and Scandinavian Simvastatin Survival Study (4S)4 trials have shown statins to be as effective in the elderly as in younger populations.5 The NLA Recommendations for Patient-Centered Management of Dyslipidemia... more
JEREMY VAN’T HOF, MD DANIEL A. DUPREZ, MD, PhD, FNLA	Case Study: Statin Use in the Elderly: An Age-Old Question Ms. K is an 83-year-old female who presents to clinic for a second opinion regarding management of cardiac risk factors. She first presented to clinic two years ago with chest pain and shortness of breath, both at rest and with exertion. Her medical history included hypertension and hyperlipidemia but no prior cardiovascular disease (CVD) and no smoking history nor diabetes. Her medications included daily aspirin 81mg, lisinopril 10mg, and metoprolol tartrate 25mg twice daily (BID). Blood... more
DANIEL A. DUPREZ, MD, PhD, FNLA	Chapter Update: News from MWLA The Midwest Lipid Association (MWLA) — alongside the Southwest Chapter — was proud to organize the 2016 Spring Clinical Lipid Update in San Diego this past March. The meeting was well-attended and very favorably reviewed. It featured an excellent faculty presenting talks on novel research in clinical lipidology as well as practical applications of lipid management. It is in a spirit of collegiality that the Midwest Chapter moves forward this year. The Board of Directors has... more
DAVID NEFF, DO	Member Spotlight: David Neff, DO David Neff, DO, has worked closely with the National Lipid Association and its members since 2003, and now volunteers his time as a member to help carry out its mission. Dr. Neff’s interest in lipidology originated from a research assignment that focused on cholesterol fed rodents with fatty liver during his undergraduate career at Michigan State University. While at Merck & Co. from late 2000 until 2014, Dr. Neff supported several cardiovascular brands in hypertension and lipids. He... more
	Education and Meeting News and Notes Registration Now Open for Spring CLU Register for the National Lipid Association’s Spring Clinical Lipid Update February 24–26, 2016, at the Hyatt Regency Phoenix. Don’t miss featured sessions on: New Paradigms for Cardiovascular Prevention, Familial Combined Hypercholesterolemia, and many more. Make sure to check lipid.org/springclu for updated agenda information and to register. NLA Call for Abstracts The NLA is accepting abstracts... more