Medscape InDiscussion: Dyslipidemia

Peter Toth, preventive cardiology leader with PCSK9 and LDL expertise, and Erin Michos, cardiovascular prevention clinician-scientist, discuss nonstatin therapies and practical implementation. They cover PCSK9 inhibitors vs apheresis, inclisiran and bempedoic acid, managing triglycerides and lipoprotein(a). They also tackle access barriers and safety of very low LDL levels.

Kim Williams, cardiologist and preventive cardiology leader known for expertise in plant-based nutrition. He contrasts dietary patterns with specific diets. He discusses saturated fat versus refined carbs, whether plant-based eating can lower cholesterol without statins, microbiome and TMAO links to animal protein, intermittent fasting for weight and cardiovascular risk, and supplements like CoQ10 and red yeast rice.

Drs Laurence Sperling and Neil Stone put key messages from the 2018 cholesterol guidelines into a clear clinical context. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/958747). The topics and discussions are planned, produced, and reviewed independently of our advertiser. This podcast is intended only for US healthcare professionals. Resources 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625 ASCVD Risk Estimator Plus https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/ 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia https://www.jacc.org/doi/10.1016/j.jacc.2021.06.011 What Do US Physicians and Patients Think About Lipid‐Lowering Therapy and Goals of Treatment? Results From the GOULD Registry https://www.ahajournals.org/doi/10.1161/JAHA.120.020893 Statin Treatment and Muscle Symptoms: Series of Randomised, Placebo Controlled n-of-1 Trials https://www.bmj.com/content/372/bmj.n135

Drs Larry Sperling and Karol Watson discuss health equity and social determinants of health for populations with dyslipidemia. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/958746). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625 Use of Risk Assessment Tools to Guide Decision-Making in the Primary Prevention of Atherosclerotic Cardiovascular Disease https://www.ahajournals.org/doi/10.1161/CIR.0000000000000638 New AMA Policies Recognize Race as a Social, Not Biological, Construct https://www.ama-assn.org/press-center/press-releases/new-ama-policies-recognize-race-social-not-biological-construct Race/Ethnicity, Neighborhood Socioeconomic Status and Cardio-metabolic Risk https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7397689/ Disparities in Hypertension and Cardiovascular Disease in Blacks: The Critical Role of Medication Adherence https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638710/ Racial and Ethnic Disparities in Heart and Cerebrovascular Disease Deaths During the COVID-19 Pandemic in the United States https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191372/

In this episode, host Dr Laurence Sperling and guests talk about how COVID affected patient-partnered dyslipidemia care, causing clinical teams to innovate. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/958311). The topics and discussions are planned, produced, and reviewed independently of our advertiser. This podcast is intended only for US healthcare professionals. Resources Patel P, Dhindsa D, Eapen DJ, et al. Optimizing the potential for telehealth in cardiovascular care (in the era of COVID-19): time will tell. Am J Med. 2021;134:945-951. doi:10.1016/j.amjmed.2021.03.007 American Medical Association. Telemedicine and team-based care: improve patient care and team engagement by using team-based care in telemedicine. https://edhub.ama-assn.org/steps-forward/module/2781279 Bhaskar S, Bradley S, Chattu VK, et al. Telemedicine as the new outpatient clinic gone digital: position paper from the Pandemic Health System REsilience PROGRAM (REPROGRAM) International Consortium (part 2). Front Public Health. 2020;8:410. doi:10.3389/fpubh.2020.00410 Arevian AC, Springgate B, Jones F, et al. The Community and Patient Partnered Research Network (CPPRN): application of patient-centered outcomes research to promote behavioral health equity. Ethn Dis. 2018;28(Suppl 2):295-302. doi: 10.18865/ed.28.S2.295. Stewart MP, Fink R, Kosirog E, Saseen JJ. Bridging health disparities: a national survey of ambulatory care pharmacists in underserved areas. Pharm Pract (Granada). 2021;19:2359. doi:10.18549/PharmPract.2021.2.2359 Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Circulation. 2019 Jun 18;139(25):e1182-e1186]. Circulation. 2019;139(25):e1082-e1143. Golden RL. William Osler at 150: An Overview of a Life. JAMA. 1999;282:2252–2258. doi:10.1001/jama.282.23.2252

Katherine Wilemon, founder and CEO of the FH Foundation and long-time patient-advocate, shares her journey from personal heart attack to building a national FH registry. The conversation covers recognizing familial hypercholesterolemia, cascade family screening, registry insights on disparities and treatment gaps, and current therapies from statins to PCSK9 inhibitors.