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Last Updated: Friday, 18-Sep-2015 16:00:00 EDT

Part Two Provides New Recommendations for Managing Cholesterol in Diverse and Underrepresented Ethnic and Racial Groups Along with Recommendations that Cross the Life Span from Children to Seniors with Lifestyle Therapies as Foundation

Last Updated: Friday, 28-Aug-2015 16:00:00 EDT

Following a June 2015 recommendation by the U.S Food and Drug Administration’s (FDA) Endocrinologic and Metabolic Drugs Advisory Committee, the FDA has approved evolocumab for use in addition to diet and maximally-tolerated statin therapy in adult patients with heterozygous familial hypercholesterolemia (HeFH), homozygous familial hypercholesterolemia (HoFH), or clinical atherosclerotic cardiovascular disease, such as heart attacks or strokes, who require additional lowering of LDL cholesterol. Evolocumab is produced by Amgen, and known by the brand name Repatha.

The Foundation of the National Lipid Association continues to make strides to help educate and promote clinical lipidology — both to clinicians and to the public.

Article By:

ANNE C. GOLDBERG, MD, FNLA
President, Foundation of the National Lipid Association
Associate Professor of Medicine
Washington University School of Medicine
St. Louis, MO

Diplomate, American Board of Clinical Lipidology

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Author Edwin Ferguson, MD, is a 70-year-old practicing preventive cardiologist and certified clinical lipidologist who, despite 20 years of treatment for dyslipidemia, recently had an ST elevation myocardial infarction (STEMI). His cardiovascular journey began in medical school when, despite his normotension and normal weight, testing revealed a triglyceride (TG)/high-density lipoprotein (HDL) axis abnormality.1(Table 1) A decade later, his lipid panel remained abnormal and untreated.

Article By:

EDWIN FERGUSON, MD, FNLA
Emeritus Professor of Medicine
University of Wisconsin School of Medicine
Madison, WI

Diplomate, American Board of Clinical Lipidology

THOMAS D. DAYSPRING, MD, FACP, NCMP, FNLA
Foundation for Health Improvement and Technology
Richmond, VA

Diplomate, American Board of Clinical Lipidology

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After the clinical studies, Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglyceride and Impact on Global Health Outcomes (AIM-HIGH) and Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE), the National Lipid Association released a statement on the use of niacin: “We believe that niacin remains a valuable adjunct to statin treatment for LDL-C lowering, and a valuable statin alternative in statin intolerant patients.”1

Article By:

TERRANCE J. MORAN, MD, FACC, FAHA
Director, Advance Lipid Management Program
Tyler Heart Institute, Community Hospital of the Monterey Peninsula
Monterey, CA
Associate Clinical Professor of Family Practice
University of California at San Francisco

Diplomate, American Board of Clinical Lipidology

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Introduction

Article By:

MERLE MYERSON, MD, EdD, FACC, FNLA
Director, Mount Sinai Roosevelt and St. Luke’s Hospitals
Cardiovascular Disease Prevention Program & Lipid Clinic
Pre-Exercise Heart Screening Program
Cardiology Section, Institute for Advanced Medicine/HIV

Diplomate, American Board of Clinical Lipidology

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Introduction

Article By:

DON P. WILSON, MD, FNLA
Department of Pediatrics
Pediatric Endocrinology and Diabetes
Cook Children’s Medical Center
Fort Worth, TX

Diplomate, American Board of Clinical Lipidology

PIERS R. BLACKETT, MD, FNLA
Department of Pediatrics
University of Oklahoma Health Sciences Center
Oklahoma City, OK

Diplomate, American Board of Clinical Lipidology

CATHERINE McNEAL, MD, PhD, FNLA
Department of Pediatrics
Department of Internal Medicine
Division of Cardiology
Scott & White Healthcare
Temple, TX

Diplomate, American Board of Clinical Lipidology

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A 51-year-old female with a history of premature coronary heart disease and coronary artery bypass grafting at age 36 was referred for hyperlipidemia. She had untreated low-density lipoprotein cholesterol (LDL-C) >600 mg/dL, a previous cholecystectomy, and non-alcoholic fatty liver. On maximal medical therapy with rosuvastatin 40 mg per day, ezetimibe 10 mg per day, and extended-release niacin 1,000 mg per day, lipid levels remained elevated; LDL apheresis was added.

Article By:

JAMES A. TRIPPI, MD

Lipidologist, Complex Cholesterol Center
St. Vincent Health
Indianapolis, IN

 

Diplomate, American Board of Clinical Lipidology

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Lifestyle-related risk factors can prevent or promote atherosclerotic cardiovascular disease (ASCVD). Thus, management of lifestyle factors is crucial in addressing the burden of ASCVD. Nonetheless, addressing these factors has often been overshadowed by the administration of medications. Over the past few years, there has been increasing interest in a key lifestyle component — exercise — and its influence on cardiovascular disease (CVD) risk.

Article By:

KAVITA S. SHARMA, MD

The Ohio State University Wexner Medical Center
Department of Medicine, Division of Cardiovascular Medicine
Columbus, Ohio

Diplomate, American Board of Clinical Lipidology

MARTHA GULATI, MD, MS, FACC, FAHA

The Ohio State University Wexner Medical Center
Department of Medicine, Division of Cardiovascular Medicine
Columbus, Ohio

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Patients with chronic kidney disease (CKD) including those undergoing dialysis have an increased risk of premature cardiovascular disease (CVD).1 CKD patients also have a high rate of coronary death and myocardial infarction — rates equivalent to those of diabetics.

Article By:

LAKSHMI KANNAN, MD, MSc

Department of Medicine
Einstein Medical Center
Philadelphia, PA

JANANI RANGASWAMI, MD, FACP

Department of Medicine
Einstein Medical Center
Philadelphia, PA
Delaware Valley Nephrology Associates
Philadelphia, PA

EDGAR V. LERMA, MD, FNLA

Section of Nephrology
UIC/Advocate Christ Medical Center
Oak Lawn, IL

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