Cardiometabolics in Children or Lipidology for Kids. Stanley J Goldberg MD Diplomate: American Board of Clinical Lipidology Tucson, Az
|
|
- Harry Watts
- 5 years ago
- Views:
Transcription
1 Cardiometabolics in Children or Lipidology for Kids Stanley J Goldberg MD Diplomate: American Board of Clinical Lipidology Tucson, Az
2 No disclosures for this Presentation
3 Death Risk Approximately 40% of the US population die as the result of Cardiovascular Disease
4 Question #1 DOES ATHEROSCLEROSIS START IN CHILDREN?
5 Korean War Autopsy Series 300 autopsies - 73% had some coronary atherosclerosis Mean age = 22.6 yrs 6% had severe lesions 50% or greater narrowing Enos WF, JAMA: 152:
6 Viet War : Autopsy /Coronary Lesions/ US Soldiers 105 autopsies for coronary lesions Mean age = 22.1 yrs 45% had some coronary atherosclerosis 5% had severe Lesions McNamara JJ, JAMA 1971;216(7):
7 Bogalusa Heart Study 93 deaths with full risk factor data % of patients with with fibrous Coronary Artery plaques by age Berensen G et al NEJM 338:
8 Question #2 IS ATHEROSCLEROSIS MORE COMMON IN CHILDREN WITH CVD RISK FACTORS?
9 Bogalusa: % of total Intima covered by plaque vs # of risk factors But atherosclerosis is never uniform through a vessel
10 QUESTION # 3 SINCE ATHEROSCLEROSIS STARTS IN CHILDREN, SHOULD WE SCREEN FOR RISK FACTORS IN CHILDREN?
11 NHLBI Pediatric Screening Recommendations Selective screening of Lipid Profile >2 years of age Universal Screening of Lipid Profile : 9-11 years of age years of age every 5 years thereafter Endorsed by: American Academy of Pediatrics American Heart Association National Lipid Association Pediatrics 2011; (Suppl 5) S1-S44
12
13 Hetrozygous Familial Hyperlipidemia (FH) was the Original Focus For Screening FH is a loss of function of the gene for the LDL receptor Criteria: Simon-Broome and Dutch Lipid Clinic Suspect FH In children when LDL C > 156 mg/dl 156 high sens, low spec, 190- low sens, high spec Incidence is 1: in general population Special Populations- incidence is 1:67 Genetic test available with 50% + detection
14 Is FH Worth Screening For? 1. Mortality for Myocardial Infarct in FH is : 100 X greater than non-fh at ages years 4X greater at ages years 2. Those with untreated FH have a dramatic increase in coronary vascular disease after 20 years of age 3. Early treatment appears to avoid coronary vascular disease Rx is with statins, ezetimibe, resins, PCSK9 antibodies
15 Identification of FH Patients by country
16 Cascade Screening (save a parent, grandparent or other family member) FH is a dominant with very high penetrance Once a patient with FH is identified it is imperative to screen up and down the family tree of the index patient and index case and siblings.
17 Screening Also Will Detect other Lipid Abnormalities: A. Cholestertol Hyperabsorbers B. Dysfunctional LDL Receptor C. Metabolic Syndrome D. Genetic Triglyceride Disorders E. Low HDL F. Rare Genetic Disorders G. Adverse Reactions to Meds (e.g. acne treatment)
18 Control of Blood Lipids Normal Value Genetic Control Diet Control Exercise control LDL <100 mg/dl Trigs <90 mg/dl HDL >40 M >50F ?
19 NHLBI Lipid Recommendations But where did it come from? Pediatrics 2011; 128:S6 TO AGE 19 Acceptable Borderline High LDL < >130 HDL >45 Trigs < =/> YEARS LDL < >160 HDL >45 Trigs < >150
20 TIP: FAMILY HISTORY IS VERY IMPORTANT
21 Other Genetic Dyslipidemias for Kids 1. 10% of population have elevated Lipoprotein (a) % have cholesterol hyperabsorption (gut) % have diabetes type 1,2 4. 3% have other genetic dyslipidemias: HeFH, hofh, ARH, gain of function PCSK9, LAL-D Lipoprotein lipase polymorphisms, many others 5. 20% have Metabolic Syndrome due to intraabdominal fat distribution which is determined by genetics.
22 A New Genetic Factor Association of Maternal Prepregnancy Dyslipidemia With Adult Offspring Dyslipidemia in Excess of Anthropometric, Lifestyle, and Genetic Factors in the Framingham Heart Study Michael M. Mendelson, MD, ScM; Asya Lyass, PhD; Christopher J. O Donnell, MD, MPH; Ralph B. D Agostino Sr, PhD; Daniel Levy, MD CONCLUSIONS AND RELEVANCE Adult offspring dyslipidemia is associated with maternal prepregnancy dyslipidemia in excess of measured lifestyle, anthropometric, and inherited genetic factors. The findings support the possibility of a maternal epigenetic contribution to cardiovascular disease risk in the general population. Further research is warranted to determine whether ongoing public health efforts to identify and reduce dyslipidemia in young adults prior to their childbearing years may have additional potential health benefits for the subsequent generation. JAMA Cardiol. doi: /jamacardio Published online March 2, 2016.
23 Maternal pre-pregnancy LDL
24 Metabolic Syndrome Criteria for Adults Waist women > 34.5, Men >40 inches Blood Pressure =/> 135 systolic or >85 diastolic HDL <40mg/dl male or <50 mg/dl female Triglycerides =/>100 mg/dl Fasting glucose >100
25 Relationship between Waist Circumference and Visceral Adipose Tissue Accumulation Subcutaneous adipose tissue Visceral adipose tissue Front Visceral Adipose Tissue (cm 2 ) r = Waist Circumference (cm) Pouliot MC, et al. Am J Cardiol. 1994;73: ; Després JP, et al. BMJ. 2001;322:
26 Powerful Central Obesity Detector
27 Waist/Height Ratio =<.5 = very low probability of MS.5-.6 = Moderate probability of MS =>.6 = very high probability of MS Example 1: waist -31 and height -62 =.5 Example 2:waist and height -62 =.6 Khoury et al. J Am Col Cardiol :
28 Waist/Height Ratio 140 Triglycerides >.6 Fasting Glucose mg/dl <.5 mg/dl < > Waist -Height Ratio 89 Waist/Height Ratio mg/dl <5 HDL.5-.6 >.6 IU/ml Serum Insulin.5-.6 <5 > waist/height ratio waist/height Ratio
29 Carotid IMT
30 Vijasarthi A, Goldberg SJ Journal of Lipids Volume 2014, Article ID , 7 pages
31 Metabolic Syndrome- 14 y.o. boy Combination Visceral obesity Increased SQ fat Gynecomastia Note belt position
32 Change with time Visit 1 Visit 2 Visit 3 Visit 1.5 yrs BMI TSC LDL HDL Trigs Waist (jnch) W/H Ratio ALT Glucose
33 How many overweight kids are there??
34 A Sudden Heart Attack Never Occurs It Takes Years of Preparation
35
36
37 10 yo boy showing LDL change with decreasing Triglycerides LDL Triglycerides
38 % LDL Response to Ezetimibe 1/8 of the population does not have haplotype 1735C-25342A-27677T for NPC1L1 gene Hegel RA et al. Lipids in Health and Disease: 2005,4:16
39 18 year old girl 1. Elevated LDL Family history of increased LDL, T2D, MI 3. Mom demanding statin therapy 4. Mild central overweight 5. Uses celexa for anxiety 6. Excessive carbohydrate intake
40 High LDL + increased waist size 1 st Visit Zetia + Diet BMI TSC LDL HDL Tri Wt 149# 141# Ht 62 in 62 in Waist W/h.59.57
41 > 2000 persons, ages years Atherosclerosis begins in childhood with the appearance of aortic fatty streaks as early as 2 years. Coronary fatty steaks begin to form in adolescence Most persons have coronary fatty streaks by the age years. Am J Cardiol Nov 26;82(10B):30T-36T.
42 At 0-18 years, normal fasting triglycerides are: 1. =/< =/< =/ < =/< =/< 70
43 Criteria for Metabolic Syndrome include all the following except: 1. BP 2. Waist circumference 3. Triglyceride level 4. HDL Level 5. BMI 6. Serum Glucose
44 Heterozygous familial hyperlipidemia has a worldwide population frequency of: 1. 1/1,000, /100, / / /67
45 In the Netherlands 87% of patients with Hetrozygous Familial Hyperlipidemia (HeFH) have been identified. What is the estimated % of HeFH identification in the USA? 1. 60% 2. 95% 3. 25% 4. 10% 5. <2%
46 The good news is you passed Security, the bad news is you have too much intra-abdominal fat
Learning Objectives. Cholesterol and Lipids in Kids: It s a Matter of the Heart. Is Atherosclerosis a Pediatric Disease?
Scott J. Soifer, MD Professor and Vice Chair Department of Pediatrics University of California, San Francisco UCSF Benioff Children s Hospital Cholesterol and Lipids in Kids: It s a Matter of the Heart
More informationPage 1. Disclosures. Background. No disclosures
Population-Based Lipid Screening in the Era of a Childhood Obesity Epidemic: The Importance of Non-HDL Cholesterol Assessment Brian W. McCrindle, Cedric Manlhiot, Don Gibson, Nita Chahal, Helen Wong, Karen
More informationStatistical Fact Sheet Populations
Statistical Fact Sheet Populations At-a-Glance Summary Tables Men and Cardiovascular Diseases Mexican- American Males Diseases and Risk Factors Total Population Total Males White Males Black Males Total
More informationEstablished Risk Factors for Coronary Heart Disease (CHD)
Getting Patients to Make Small Lifestyle Changes That Result in SIGNIFICANT Improvements in Health - Prevention of Diabetes and Obesity for Better Health Maureen E. Mays, MD, MS, FACC Director ~ Portland
More informationCase Discussions: Treatment Strategies for High Risk Populations. Most Common Reasons for Referral to the Baylor Lipid Clinic
Case Discussions: Treatment Strategies for High Risk Populations Peter H. Jones MD, FNLA Associate Professor Methodist DeBakey Heart and Vascular Center Baylor College of Medicine Most Common Reasons for
More informationCommon Repatha Documentation Requirements for Patients With Primary Hyperlipidemia and Established CVD 1,2
Established CVD Common Repatha Documentation Requirements for Patients With Primary Hyperlipidemia and Established CVD 1,2 Primary and Secondary Diagnosis Codes Primary Diagnosis: Primary hyperlipidemia
More informationFocus on FH (Familial Hypercholesterolemia) Joshua W. Knowles, MD PhD for PCNA May, 2013
Focus on FH (Familial Hypercholesterolemia) Joshua W. Knowles, MD PhD for PCNA May, 2013 Conflicts CMO for The FH Foundation Pre-talk quiz What is cascade screening? 1. screening all family members 2.
More information!!! Aggregate Report Fasting Biometric Screening CLIENT!XXXX. May 2, ,000 participants
Aggregate Report Fasting Biometric Screening CLIENTXXXX May 2, 2014 21,000 participants Contact:404.636.9437~Website:www.atlantahealthsys.com RISK FACTOR QUESTIONNAIRE Participants Percent Do not exercise
More informationMetabolic Syndrome.
www.bmiweightloss.com.au What is the metabolic syndrome? The was first described in 1988 by Gerald Reavson It was originally described as the clustering of four conditions These conditions when present
More informationHow would you manage Ms. Gold
How would you manage Ms. Gold 32 yo Asian woman with dyslipidemia Current medications: Simvastatin 20mg QD Most recent lipid profile: TC = 246, TG = 100, LDL = 176, HDL = 50 What about Mr. Williams? 56
More informationDIAGNOSIS AND TREATMENT OF FH CHILDREN. O. GUARDAMAGNA Dipartimento di Scienze della Sanità Pubblica e Pediatriche UNIVERSITA DI TORINO
DIAGNOSIS AND TREATMENT OF FH CHILDREN O. GUARDAMAGNA Dipartimento di Scienze della Sanità Pubblica e Pediatriche UNIVERSITA DI TORINO DISCLOSURES Kowa MSD Pfizer Astrazeneca Synageva/Alexion OUTLINE Background
More informationRequest for Prior Authorization for PCSK9 inhibitor therapy Website Form Submit request via: Fax
Request for Prior Authorization for PCSK9 inhibitor therapy Website Form www.highmarkhealthoptions.com Submit request via: Fax - 1-855-476-4158 PCSK9 is a protein that reduces the hepatic removal of low-density
More informationCardiometabolic Side Effects of Risperidone in Children with Autism
Cardiometabolic Side Effects of Risperidone in Children with Autism Susan J. Boorin, MSN, PMHNP-BC PhD Candidate Yale School of Nursing 1 This speaker has no conflicts of interest to disclose. 2 Boorin
More informationYoung high risk patients the role of statins Dr. Mohamed Jeilan
Young high risk patients the role of statins Dr. Mohamed Jeilan KCS Congress: Impact through collaboration CONTACT: Tel. +254 735 833 803 Email: kcardiacs@gmail.com Web: www.kenyacardiacs.org Disclosures
More informationPharmacy Management Drug Policy
SUBJECT: ; Praluent (alirocumab), Repatha (evolocumab) POLICY NUMBER: Pharmacy-61 EFFECTIVE DATE: 8/15 LAST REVIEW DATE: 9/22/2017 If the member s subscriber contract excludes coverage for a specific service
More informationDisclosures. Pediatric Dyslipidemia Casey Elkins, DNP, NP C, CLS, FNLA. Learning Objectives. Atherogenesis. Acceptable Values
39 th National Conference on Pediatric Health Care Pediatric Dyslipidemia Casey Elkins, DNP, NP C, CLS, FNLA March 19-22, 2018 CHICAGO Disclosures Speakers Bureau Sanofi and Regeneron Learning Objectives
More informationSoo LIM, MD, PHD Internal Medicine Seoul National University Bundang Hospital
Soo LIM, MD, PHD Internal Medicine Seoul National University Bundang Hospital 1. Importance of Lowering LDL-Cholesterol in Diabetes Patients & Lipid Guidelines Prevalence of dyslipidemia in Korea Prevalence
More informationAdolescent Hypertension Roles of obesity and hyperuricemia. Daniel Landau, MD Pediatrics, Soroka University Medical Center
Adolescent Hypertension Roles of obesity and hyperuricemia Daniel Landau, MD Pediatrics, Soroka University Medical Center Blood Pressure Tables BP standards based on sex, age, and height provide a precise
More informationScreening Results. Juniata College. Juniata College. Screening Results. October 11, October 12, 2016
Juniata College Screening Results Juniata College Screening Results October 11, 2016 & October 12, 2016 JUNIATA COLLEGE The J.C. Blair Hospital CARES team screened 55 Juniata College employees on October
More informationAmerican Osteopathic College of Occupational and Preventive Medicine 2012 Mid-Year Educational Conference St. Petersburg, Florida
The 21 st Century Paradigm Shift: Prevention Rather Than Intervention for the Treatment of Stable CHD The Economic Burden of Cardiovascular Diseases Basil Margolis MD, FACC, FRCP Director, Preventive Cardiology
More informationTerm-End Examination December, 2009 MCC-006 : CARDIOVASCULAR EPIDEMIOLOGY
MCC-006 POST GRADUATE DIPLOMA IN CLINICAL CARDIOLOGY (PGDCC) 00269 Term-End Examination December, 2009 MCC-006 : CARDIOVASCULAR EPIDEMIOLOGY Time : 2 hours Maximum Marks : 60 Note : There will be multiple
More informationDisclosure. Cholesterol and Lipids in Kids: It s a Matter of the Heart. Case Disclosure
Sco$ J. Soifer, MD Professor and Vice Chair Department of Pediatrics University of California, San Francisco UCSF Benioff Children s Hospital Cholesterol and Lipids in Kids: Disclosure I have no financial
More informationOptimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden
Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden Cardiovascular Disease Prevention (CVD) Three Strategies for CVD
More informationTrial Evidences. Marjet Braamskamp Departement of Vascular Medicine/ Pediatrics Lipidology in Pediatrics 24 September 2015
Trial Evidences Marjet Braamskamp Departement of Vascular Medicine/ Pediatrics Lipidology in Pediatrics 24 September 2015 Rosuvastatin in adults LDL reduction of 45-60% Less side effects Rosuvastatin
More informationIs Universal Pediatric Lipid Screening Justified? YES. Damon Dixon, MD, FAAP Preventative Cardiology March 7 th, 2016
Is Universal Pediatric Lipid Screening Justified? YES Damon Dixon, MD, FAAP Preventative Cardiology March 7 th, 2016 None Disclosures What is a Pediatrician? Pediatrics is the specialty of medical science
More informationMetabolic Syndrome Across the Life Cycle - Adolescent. Joy Friedman MD
Metabolic Syndrome Across the Life Cycle - Adolescent Joy Friedman MD Disclosures I have no actual or potential conflict of interest in relation to this program or presentation. I will mention off-label
More informationTest5, Here is Your My5 to Health Profile with Metabolic Syndrome Insight
Test5, Here is Your My5 to Health Profile with Metabolic Syndrome Insight Quest, Quest Diagnostics, the associated logo, and all associated Quest Diagnostics marks are the registered trademarks of Quest
More informationReview current guideline recommendations for lipid-lowering therapy
Breakout Session #3 New Paradigms in the Management of Dyslipidemia Review current guideline recommendations for lipid-lowering therapy Dr Meral KAYIKCIOGLU Ege University Medical School, Cardiology Dept,
More informationTotal risk management of Cardiovascular diseases Nobuhiro Yamada
Nobuhiro Yamada The worldwide burden of cardiovascular diseases (WHO) To prevent cardiovascular diseases Beyond LDL Multiple risk factors With common molecular basis The Current Burden of CVD CVD is responsible
More informationRepatha. Repatha (evolocumab) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.16.08 Subject: Repatha Page: 1 of 8 Last Review Date: September 18, 2015 Repatha Description Repatha
More information3/25/2010. Age-adjusted incidence rates for coronary heart disease according to body mass index and waist circumference tertiles
Outline Relationships among Regional Adiposity, Physical Activity, and CVD Risk Factors: Preliminary Results from Two Epidemiologic Studies Molly Conroy, MD, MPH Obesity Journal Club February 18, 2010
More informationRisk Factors for Heart Disease
Risk Factors for Heart Disease Risk Factors we cannot change (Age, Gender, Family History) Risk Factors we can change (modifiable) Smoking Blood pressure Cholesterol Diabetes Inactivity Overweight Stress
More informationDiabetes and Cardiovascular Risk Management Denise M. Kolanczyk, PharmD, BCPS-AQ Cardiology
Diabetes and Cardiovascular Risk Management Denise M. Kolanczyk, PharmD, BCPS-AQ Cardiology Disclosures In compliance with the accrediting board policies, the American Diabetes Association requires the
More informationHow to Reduce Residual Risk in Primary Prevention
How to Reduce Residual Risk in Primary Prevention Helene Glassberg, MD Assistant Professor of Medicine Section of Cardiology Hospital of the University of Pennsylvania Philadelphia, PA USA Patients with
More informationLipid Management C. Samuel Ledford, MD Interventional Cardiology Chattanooga Heart Institute
Lipid Management 2018 C. Samuel Ledford, MD Interventional Cardiology Chattanooga Heart Institute Disclosures No Financial Disclosures Disclosures I am an Interventional Cardiologist I put STENTS in for
More informationObjectives. Objectives. Alejandro J. de la Torre, MD Cook Children s Hospital May 30, 2015
Alejandro J. de la Torre, MD Cook Children s Hospital May 30, 2015 Presentation downloaded from http://ce.unthsc.edu Objectives Understand that the obesity epidemic is also affecting children and adolescents
More informationMetabolic Syndrome: An overview. Kevin Niswender MD, PhD Vanderbilt University School of Medicine
Metabolic Syndrome: An overview. Kevin Niswender MD, PhD Vanderbilt University School of Medicine Setting the scene GB, 43 yo AA man followed for hypothyroidism returns on LT4 125 mcg/d and has a TSH=1.1
More informationPediatric Dyslipidemia: Angela Gooden MSN, RN, CPNP- AC/PC, Texas Children s Hospital, Pediatric Cardiology
Pediatric Dyslipidemia: Angela Gooden MSN, RN, CPNPAC/PC, Texas Children s Hospital, Pediatric Cardiology Objectives Define pediatric dyslipidemia Describe the association between pediatric dyslipidemia
More informationDiabetes and Heart Disease. Sarah Alexander, MD, FACC Assistant Professor of Medicine Rush University Medical Center
Diabetes and Heart Disease Sarah Alexander, MD, FACC Assistant Professor of Medicine Rush University Medical Center No conflicts of interest or financial relationships to disclose. 2 What s the problem??
More informationFasting or non fasting?
Vascular harmony Robert Chilton Professor of Medicine University of Texas Health Science Center Director of Cardiac Catheterization labs Director of clinical proteomics Which is best to measure Lower continues
More informationThe Metabolic Syndrome Update The Metabolic Syndrome Update. Global Cardiometabolic Risk
The Metabolic Syndrome Update 2018 Marc Cornier, M.D. Professor of Medicine Division of Endocrinology, Metabolism & Diabetes Anschutz Health and Wellness Center University of Colorado School of Medicine
More informationClinical Study Assessment of Metformin as an Additional Treatment to Therapeutic Lifestyle Changes in Pediatric Patients with Metabolic Syndrome
Cholesterol Volume 2012, Article ID 961410, 5 pages doi:10.1155/2012/961410 Clinical Study Assessment of Metformin as an Additional Treatment to Therapeutic Lifestyle Changes in Pediatric Patients with
More informationRepatha. Repatha (evolocumab) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.40.08 Subject: Repatha Page: 1 of 8 Last Review Date: December 2, 2016 Repatha Description Repatha (evolocumab)
More informationMetabolic Syndrome: Why Should We Look For It?
021-CardioCase 29/05/06 15:04 Page 21 Metabolic Syndrome: Why Should We Look For It? Dafna Rippel, MD, MHA and Andrew Ignaszewski, MD, FRCPC CardioCase presentation Andy s fatigue Andy, 47, comes to you
More informationMetabolic Syndrome. Shon Meek MD, PhD Mayo Clinic Florida Endocrinology
Metabolic Syndrome Shon Meek MD, PhD Mayo Clinic Florida Endocrinology Disclosure No conflict of interest No financial disclosure Does This Patient Have Metabolic Syndrome? 1. Yes 2. No Does This Patient
More informationMOLINA HEALTHCARE OF CALIFORNIA
MOLINA HEALTHCARE OF CALIFORNIA HIGH BLOOD CHOLESTEROL IN ADULTS GUIDELINE Molina Healthcare of California has adopted the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel
More informationEVOLOCUMAB Generic Brand HICL GCN Exception/Other EVOLOCUMAB REPATHA 42378
Generic Brand HICL GCN Exception/Other EVOLOCUMAB REPATHA 42378 This drug requires a written request for prior authorization. All requests for Repatha (evolocumab) require review by a pharmacist prior
More informationHealth Score SM Member Guide
Health Score SM Member Guide Health Score Your Health Score is a unique, scientifically based assessment of seven critical health indicators gathered during your health screening. This number is where
More informationIdentification and management of familial hypercholesterolaemia (FH) - An overview
Identification and management of familial hypercholesterolaemia (FH) - An overview National Collaborating Centre for Primary Care and Royal College of General Practitioners NICE Guideline CG 71 (August
More informationCardiovascular disease and diabetes Vascular harmony
Cardiovascular disease and diabetes 2018 Vascular harmony Robert Chilton Professor of Medicine University of Texas Health Science Center Director of Cardiac Catheterization labs Director of clinical proteomics
More informationKnow Your Numbers. The Life Saving Numbers You Need To Know
Know Your Numbers The Life Saving Numbers You Need To Know Take Charge of Your! You may have heard that you need to Know Your Numbers, which refers to key markers of heart health like blood pressure, waist
More informationCardiovascular Complications of Diabetes
VBWG Cardiovascular Complications of Diabetes Nicola Abate, M.D., F.N.L.A. Professor and Chief Division of Endocrinology and Metabolism The University of Texas Medical Branch Galveston, Texas Coronary
More informationFamilial hypercholesterolaemia
Familial hypercholesterolaemia Jaimini Cegla MRCP FRCPath PhD Consultant in Chemical Pathology and Metabolic Medicine Hammersmith Hospital Lipid Clinic 20 April 2017 An unrecognised, potentially fatal,
More informationMetabolic Syndrome. Bill Roberts, M.D., Ph.D. Professor of Pathology University of Utah
Metabolic Syndrome Bill Roberts, M.D., Ph.D. Professor of Pathology University of Utah Objectives Be able to outline the pathophysiology of the metabolic syndrome Be able to list diagnostic criteria for
More informationComprehensive Treatment for Dyslipidemias. Eric L. Pacini, MD Oregon Cardiology 2012 Cardiovascular Symposium
Comprehensive Treatment for Dyslipidemias Eric L. Pacini, MD Oregon Cardiology 2012 Cardiovascular Symposium Primary Prevention 41 y/o healthy male No Medications Normal BP, Glucose and BMI Social History:
More informationContemporary management of Dyslipidemia
Contemporary management of Dyslipidemia Todd Anderson Feb 2018 Disclosure Statement Within the past two years: I have not had an affiliation (financial or otherwise) with a commercial organization that
More informationAndrew Cohen, MD and Neil S. Skolnik, MD INTRODUCTION
2 Hyperlipidemia Andrew Cohen, MD and Neil S. Skolnik, MD CONTENTS INTRODUCTION RISK CATEGORIES AND TARGET LDL-CHOLESTEROL TREATMENT OF LDL-CHOLESTEROL SPECIAL CONSIDERATIONS OLDER AND YOUNGER ADULTS ADDITIONAL
More informationPIEDMONT ACCESS TO HEALTH SERVICES, INC. Guidelines for Screening and Management of Dyslipidemia
PIEDMONT ACCESS TO HEALTH SERVICES, INC. Policy Number: 01-09-021 SUBJECT: Guidelines for Screening and Management of Dyslipidemia EFFECTIVE DATE: 04/2008 REVIEWED/REVISED: 04/12/10, 03/17/2011, 4/10/2012,
More informationMetabolic Syndrome in Asians
Metabolic Syndrome in Asians Alka Kanaya, MD Asst. Professor of Medicine, UCSF Asian CV Symposium, November 17, 2007 The Metabolic Syndrome Also known as: Syndrome X Insulin Resistance Syndrome The Deadly
More informationCurrent Cholesterol Guidelines and Treatment of Residual Risk COPYRIGHT. J. Peter Oettgen, MD
Current Cholesterol Guidelines and Treatment of Residual Risk J. Peter Oettgen, MD Associate Professor of Medicine Harvard Medical School Director, Preventive Cardiology Beth Israel Deaconess Medical Center
More informationWORKSHOP 1. Management of Patients with Familial Hypercholesterolemia
WORKSHOP 1 Management of Patients with Familial Hypercholesterolemia Tutors: Manal Al-Kindi (Oman)/ Gilles Lambert (France) (Case 1) Zuhier Awan (KSA)/ Raul Santos (Brazil) (Case 2) Khalid Al-Waili (Oman)/
More informationUnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2017 P 2063-8 Program Prior Authorization/Medical Necessity Medication Repatha (evolocumab) P&T Approval Date 5/2015, 9/2015, 11/2015,
More information7/6/2012. University Pharmacy 5254 Anthony Wayne Drive Detroit, MI (313)
University Pharmacy 5254 Anthony Wayne Drive Detroit, MI 48202 (313) 831-2008 Be able to identify the signs of a heart attack or stoke Identify what puts you at a higher risk for cardiovascular disease,
More informationElements for a Public Summary
VI.2 Elements for a Public Summary / / 10 mg/10 mg tablets / / 10 mg/20 mg tablets / / 10 mg/40 mg tablets / / 10 mg/80 mg tablets VI.2.1 Overview of disease epidemiology Prevention of cardiovascular events
More informationPlasma fibrinogen level, BMI and lipid profile in type 2 diabetes mellitus with hypertension
World Journal of Pharmaceutical Sciences ISSN (Print): 2321-3310; ISSN (Online): 2321-3086 Published by Atom and Cell Publishers All Rights Reserved Available online at: http://www.wjpsonline.org/ Original
More informationHypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents
Hypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents Stella Stabouli Ass. Professor Pediatrics 1 st Department of Pediatrics Hippocratio Hospital Evaluation of
More informationSelected Overweight- and Obesity- Related Health Disorders
Selected Overweight- and Obesity- Related Health Disorders HIGHLIGHTS Obesity and overweight are predisposing factors for the development of type 2 diabetes mellitus, coronary heart disease, stroke, osteoarthritis
More informationCardiovascular Disease Risk Factors:
Cardiovascular Disease Risk Factors: Risk factors are traits or habits that increase a person's chances of having cardiovascular disease. Some risk factors can be changed. These risk factors are high blood
More informationLow-density lipoprotein as the key factor in atherogenesis too high, too long, or both
Low-density lipoprotein as the key factor in atherogenesis too high, too long, or both Lluís Masana Vascular Medicine and Metabolism Unit. Sant Joan University Hospital. IISPV. CIBERDEM Rovira i Virgili
More informationPREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN
1980 to 2000: Death rate fell from: 542.9 to 266.8 per 100K men 263.3 to 134.4 per 100K women 341,745 fewer deaths from CHD in 2000 Ford ES, NEJM, 2007 47% from CHD treatments, 44% from risk factor modification
More informationLIPID CLUB Rome, 2014
LIPID CLUB Rome, 2014 June the 6h 6th Hyperlipidaemia in FH Children Ornella Guardamagna University of Torino DICLOSURES Medpace Kowa DSMB member MSD, Pfizer, Synageva Investigator in industry funded trials
More informationPreclinical Detection of CAD: Is it worth the effort? Michael H. Crawford, MD
Preclinical Detection of CAD: Is it worth the effort? Michael H. Crawford, MD 1 Preclinical? No symptoms No physical findings No diagnostic ECG findings No chest X-ray X findings No diagnostic events 2
More informationLong-Term Complications of Diabetes Mellitus Macrovascular Complication
Long-Term Complications of Diabetes Mellitus Macrovascular Complication Sung Hee Choi MD, PhD Professor, Seoul National University College of Medicine, SNUBH, Bundang Hospital Diabetes = CVD equivalent
More informationPrevention of Heart Disease: The New Guidelines
Prevention of Heart Disease: The New Guidelines Nisha I. Parikh MD MPH Assistant Professor of Medicine Division of Cardiology Department of Medicine University of California San Francisco May 18 th 2015
More informationDiabetes Mellitus: A Cardiovascular Disease
Diabetes Mellitus: A Cardiovascular Disease Nestoras Mathioudakis, M.D. Assistant Professor of Medicine Division of Endocrinology, Diabetes, & Metabolism September 30, 2013 1 The ABCs of cardiovascular
More information4/14/2018 DYSLIPIDEMIA CASES. Mary Malloy, MD. I have nothing to disclose
DYSLIPIDEMIA CASES Mary Malloy, MD I have nothing to disclose 1 Case 1 A 24 year old healthy, slender woman is referred because she has a family history of premature CAD (mother, age 59, had onset of angina
More informationThe American Diabetes Association estimates
DYSLIPIDEMIA, PREDIABETES, AND TYPE 2 DIABETES: CLINICAL IMPLICATIONS OF THE VA-HIT SUBANALYSIS Frank M. Sacks, MD* ABSTRACT The most serious and common complication in adults with diabetes is cardiovascular
More informationSimvastatin With or Without Ezetimibe in Familial Hypercholesterolemia
Simvastatin With or Without Ezetimibe in Familial Hypercholesterolemia The trial ClinicalTrials.gov number: NCT00552097 John J.P. Kastelein, MD, PhD* Department of Vascular Medicine Academic Medical Center
More informationChapter 18. Diet and Health
Chapter 18 Diet and Health Risk Factors and Chronic Diseases Interrelationships among Chronic Diseases Chronic Disease Heart Disease and Stroke Hypertension Cancer Diabetes The Formation of Plaques in
More informationKnow Your Numbers. Your guide to maintaining good health. Helpful information from Providence Medical Center and Saint John Hospital
Know Your Numbers Your guide to maintaining good health Helpful information from Providence Medical Center and Saint John Hospital If it has been awhile since your last check up and you are searching for
More informationMarshall Tulloch-Reid, MD, MPhil, DSc, FACE Epidemiology Research Unit Tropical Medicine Research Institute The University of the West Indies, Mona,
Marshall Tulloch-Reid, MD, MPhil, DSc, FACE Epidemiology Research Unit Tropical Medicine Research Institute The University of the West Indies, Mona, Jamaica At the end of this presentation the participant
More informationEnvironmental. Vascular / Tissue. Metabolics
Global Risk Reduction--WINS Picking Mom and Dad-2016 Environmental Vascular / Tissue Metabolics Stop smoking-1b Physical activity-1b Weight control-1b Chelation therapy-3c Influenza vaccination-1b Blood
More informationHigh Blood Cholesterol What you need to know
National Cholesterol Education Program High Blood Cholesterol What you need to know Why Is Cholesterol Important? Your blood cholesterol level has a lot to do with your chances of getting heart disease.
More informationFamilial hypercholesterolaemia in children and adolescents
Familial hypercholesterolaemia in children and adolescents Rationale and recommendations for early identification and treatment European Atherosclerosis Society Consensus Panel Slide deck adapted from:
More informationBest Lipid Treatments
Best Lipid Treatments Pam R. Taub MD, FACC Director of Step Family Cardiac Rehabilitation and Wellness Center Associate Professor of Medicine UC San Diego Health System Overview of Talk Review of pathogenesis
More informationRick Fox M.A Health and Wellness Specialist
Metabolic Diseases Rick Fox M.A Health and Wellness Specialist Metabolic Diseases Metabolism is the process your body uses to get or make energy from the food you eat. Food is made up of proteins, carbohydrates
More informationEzetimib Stada 10 mg tablets
Ezetimib Stada 10 mg tablets 13.7.2016, Version V1.3 PUBLIC SUMMARY OF THE RISK MANAGEMENT PLAN VI.2 Elements for a Public Summary Ezetimib Stada 10 mg tablets VI.2.1 Overview of disease epidemiology Having
More informationYour health is a crucial aspect of your life. That s why the Yakima Heart Center offers this booklet; to help you identify the numbers that affect
Your health is a crucial aspect of your life. That s why the Yakima Heart Center offers this booklet; to help you identify the numbers that affect your health and well-being. Knowing your medical history
More informationSTATIN UTILIZATION MANAGEMENT CRITERIA
STATIN UTILIZATION MANAGEMENT CRITERIA DRUG CLASS: HMG Co-A Reductase Inhibitors & Combinations Agents which require prior review: Advicor (niacin extended-release/lovastatin) Crestor (rosuvastatin)(5mg,10mg,
More informationFigure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution
Figure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution of A: total cholesterol (TC); B: low-density lipoprotein
More informationCARDIOVASCULAR HEALTH
CARDIOVASCULAR HEALTH CONTROLLING YOUR RISK FACTORS Carina Price, RN, COHC Heart Disease The Facts Heart Disease Heart Disease is more common than decades in the past and often silent until it strikes.
More informationImaging Biomarkers: utilisation for the purposes of registration. EMEA-EFPIA Workshop on Biomarkers 15 December 2006
Imaging Biomarkers: utilisation for the purposes of registration EMEA-EFPIA Workshop on Biomarkers 15 December 2006 Vascular Imaging Technologies Carotid Ultrasound-IMT IVUS-PAV QCA-% stenosis 2 ICH E
More informationNon alcoholic fatty liver disease and atherosclerosis Raul Santos, MD
Non alcoholic fatty liver disease and atherosclerosis Raul Santos, MD Sao Paulo Medical School Hospital Sao Paulo, Brazil Disclosure Honoraria received for consult and/or speaker : Astra Zeneca, Amgen,
More informationConceptual Approach to CAD Risk. Disclosures. Integrating Imaging and Biomarkers for Optimal CVD Risk Assessment and Management 2/10/2014.
Integrating Imaging and Biomarkers for Optimal CVD Risk Assessment and Management None Disclosures Arthur Agatston Conceptual Approach to CAD Risk Devereux Circulation, 1993 1 Age Obesity Family Hx Diabetes
More informationAtherosclerotic cardiovascular disease (CVD) is the number
Recent Advances in Preventive Cardiology and Lifestyle Medicine Reduction of Risk for Cardiovascular Disease in Children and Adolescents Stephen R. Daniels, MD, PhD; Charlotte A. Pratt, PhD, RD; Laura
More informationImplications of The LookAHEAD Trial: Is Weight Loss Beneficial for Patients with Diabetes?
Implications of The LookAHEAD Trial: Is Weight Loss Beneficial for Patients with Diabetes? Boston, MA November 7, 213 Edward S. Horton, MD Professor of Medicine Harvard Medical School Senior Investigator
More informationPatient: Shawn Baker March 06, 2018
Mr. Shawn Baker Dear Participant: Our team at SpecialtyHealth has received your lab work and the results have been reviewed. In this letter you will find a summary of the results along with numerous charts
More informationInspired Functional Ingredients to Innovate and Differentiate Your Brand. Products by Ecovatec Solutions Inc.
Inspired Functional Ingredients to Innovate and Differentiate Your Brand Products by Ecovatec Solutions Inc. High Density Lipopeptides (HDL p ) High Density Lipopeptides (HDL p ) High density lipoproteins
More informationPart 1: Obesity. Dietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes 10/15/2018. Objectives.
Dietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes Stephen D. Sisson MD Objectives To review dietary recommendations in the following conditions: Obesity Hypertension Diabetes
More information