Winter 2018 LipidSpin Articles | National Lipid Association Online

JAMES A. UNDERBERG, MD, MS, FNLA	From the NLA President: Focusing on You Great organizations thrive by looking forward, and the National Lipid Association is no different. In looking forward, we must have a vision of how we will continue to grow our brand and membership, which ultimately helps advance the practice of clinical lipidology. NLA leadership, along with some special invited guests, met in Orlando for a Strategic Planning session in January to define exactly what that vision looks like. The focus of this meeting was you, the NLA member.... more
KENNETH KELLICK, PharmD, CLS, FNLA	From the NELA President: President's Views I am proud to represent the Northeast Lipid Association (NELA) as president, and in my 30th year of clinical lipidology. At the start of my practice at the the VA Medical Center (VAMC), lovastatin and ATP-1 were just introduced. In these 30 years of practice LDL-C targets have changed from 130mg/dL to less than 70mg/dL. My interaction with the National Lipid Association started at the first gathering in 2002 where SELA expanded to the current five chapters that form our organization... more
KAYE-EILEEN WILLARD, MD, FNLA	From the LipidSpin Editor: The Important Role of Lipidologists in Dispelling ASCVD Treatment Myths Among Special Populations A 52-year-old woman was referred to our Lipid Clinic several weeks ago by her primary care physician who felt overwhelmed and exasperated and was asking for assistance in her management. She presented for primary ASCVD prevention with multiple risk factors for cardiovascular disease. She was very skeptical and had many preconceived ideas gleaned from her “extensive research” on the internet and talking with family and friends, regarding lipid-lowering therapy. She quickly informed me... more
LINDA C. HEMPHILL, MD, FNLA	Clinical Feature: Evaluation of Women for the Primary Prevention of Atherosclerotic Cardiovascular Disease The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults suggest that there are four adult-treatment groups for whom moderate or high-intensity statin drugs should be prescribed, including adults with: Clinical atherosclerotic cardiovascular disease (ASCVD) Low-density lipoprotein cholesterol (LDL-C) greater than or equal to 190 mg/dL ... more
MICHAEL B. BOFFA, PhD MARLYS L. KOSCHINSKY, PhD, FAHA	Guest Editorial: Current Understanding of the Contribution of Lipoprotein(a) to Atherosclerotic Cardiovascular Disease Risk in Women It is well-established that, compared to men, post-menopausal women enjoy a degree of protection against atherosclerotic cardiovascular disease (ASCVD).¹ The rate of ASCVD in post-menopausal women matches or even exceeds that in men.¹ In spite of the pre-menopausal protection for women, ASCVD remains a major factor in morbidity and mortality in women and is, as it is for men, the largest single cause of death in women worldwide.² Gender... more
KAREN ASPRY, MD, MS, FACC, FNLA	EBM Tools for Practice: Statins for Primary Prevention in Women: How an Individual-Benefit Model Could Expand Treatment to Hypercholesterolemic Women Under Age 65 with 10-Year ASCVD Risk Less Than 7.5% Evidence in support of statins for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) in women was sparse until recently.¹ However, meta-analyses have documented that statins significantly reduce ASCVD event rates in women with elevated baseline risk.^2,3,4 Yet a large subset of women under age 70 with hypercholesterolemia but no other risk factors does not reach the current threshold for statin eligibility, i.e., 7.5% absolute ASCVD... more
ALEXIS WHITE, PharmD BETHANY WATTENGEL, PharmD MEGAN SKELLY, PharmD KENNETH KELLICK, PharmD, CLS, FNLA	Lipid Luminations: Hormone Replacement Therapy and Cardiovascular Risk Hormone replacement therapy (HRT) in post-menopausal women has been a topic of constant debate. HRT with conjugated equine estrogens (CEE) or conjugated equine estrogens with progesterone, was perceived not only to relieve vasomotor symptoms associated with menopause but also to protect against osteoporosis and heart disease in these women.1,2,3 That belief later was contradicted when new data suggested an increased risk of breast cancer with little protection from heart disease was... more
MEGAN L. BANKERT KAYLA NAJAFIPOUR, PharmD SALEEM NAINA, PharmD SUZANNE MESIDOR, MD, FACOG	Specialty Corner: Conventional and Non-Conventional Treatment Options for Post-Menopausal Symptoms Up to 80 percent of post-menopausal women suffer from a variety of symptoms related to decreased estrogen. The most common symptoms are vasomotor symptoms (VMS) such as hot flashes and night sweats. Painful intercourse, vaginal dryness, and urinary incontinence are considered vulvovaginal atrophy or part of the genitourinary syndrome of menopause (GSM). Each symptom is a result of a physiological change stemming from lack of estrogen and can last for a decade in some women.^{1... more}
ADINA S. GUTSTEIN, MSN, CRNP, CLS, FPCNP	Practical Pearls: Severe Hypertriglyceridemia in a 40-Year-Old Woman: Using the ApoB App to Confirm a Diagnosis and Target Future Cardiovascular Risk Case History Mary is a 40-year-old school teacher who was referred for severe elevation of triglycerides (TGs). She has a past medical history of hypertension, gestational diabetes, pregnancy-induced hypertension, former tobacco use and idiopathic gastroparesis. She was not pregnant at the initial consultation, and reported regular menses. She denied knowledge of hypertriglyceridemia during pregnancy. Family history was notable for premature coronary heart disease (... more
DOUGLAS S. JACOBY, MD, FNLA TINA DAVIS, CRNP, CLS, FNLA MONIKA SANGHAVI, MD	Case Study: Management of Hypercholesterolemia in Young Women of Childbearing Years and During Pregnancy JK is a 35-year-old female nonsmoker who first presented to clinical lipidology care after developing angina while breastfeeding her first child. A subsequent cardiac catheterization revealed 3-vessel disease, ultimately leading to coronary artery bypass grafting (CABG). Her low-density lipoprotein cholesterol (LDL-C) was 419 mg/dL. Her father has hypercholesterolemia and underwent CABG before age 40, after his first myocardial infarction. JK was first diagnosed with... more
EDWARD M. GOLDENBERG, MD, FNLA	Chapter Update: Refocusing Efforts on Membership Retension The Northeast Lipid Association executive committee held two meetings in 2017 and we reached consensus that we need to refocus efforts on membership retention and access to new members. The National Lipid Association is working separately on this process as well, and has created an outreach program for membership retention. The NELA hopes to bring this closer to home and support the NLA efforts. We think that one of the best ways to keep members engaged and to recruit new members is... more
RODA PLAKOGIANNIS, PharmD, BS, BCPS, CLS, FNLA	Member Spotlight: Roda Plakogiannis, PharmD, BS, BCPS, CLS, FNLA What motivated you to become a member of the NLA? A: My passion for lipid management had amplified during my ambulatory care pharmacy residency, where I participated in the pharmacy driven clinics, in part, managing patients with dyslipidemia. Upon completing my residency and beginning my career in academia, a colleague shared an email introducing the NLA and that they were having a conference in the New York City area. I jumped at the opportunity to attend the... more
Aspry	Member Spotlight: Karen E. Aspry, MD, MS, FNLA Q: What motivated you to become a member of the NLA? A: My background in human nutrition oriented me towards cardiovascular disease prevention in medical school and training. In 2004, I was a clinical and invasive cardiologist with Kaiser Permanente in Northern California and working in their lipid management program. I attended an American Heart Association- sponsored Lipid Training Course at UCSF’s Gladstone Institute taught by Dr. Tom Bersot, and he told me... more
ANNE C. GOLDBERG, MD, FNLA	Foundation Update The Foundation continues to be thankful for another successful year in 2017. As the President of the Foundation of the National Lipid Association (NLA), I want to thank each and every one of you who made a contribution and supported our great Association. Last year was a big year for the Foundation. We updated our mission and vision statements, designed and launched a brand-new website (www. learnyourlipids.com), and held multiple... more