cholesterol Tag

19 Oct

Posted at 12:52h in Mens' Health

Health Screening Notice: Screening recommendations differ between countries and change over time, and the right tests and intervals depend on your age, family history and risk factors. Screening is not a substitute for medical care: see a doctor promptly for symptoms such as chest pain, shortness of breath, blood in the stool, unexplained weight loss or urinary changes, even if recent results were normal. This post is for general information only. Clinics named or linked in this post are not warranted or endorsed by MedicalResearch.com or Eminent Domains Inc.

Screening is one of the most studied areas of medicine, and the evidence for it is more nuanced than the marketing around it. For men over 35, the research supports a clear conclusion: targeted, regular screening for the right conditions can catch disease earlier, but the details matter.

Cardiovascular disease remains the single largest cause of death for men in most high-income and middle-income countries. Large cohort studies and clinical guidelines consistently support blood pressure measurement from early adulthood and lipid assessment from around age 35 to 40, earlier where family history is significant. Some guidelines also support adding ApoB to standard lipid panels, because it counts atherogenic particles more directly than LDL cholesterol and can refine risk prediction.

[caption id="attachment_76645" align="aligncenter" width="500"]Photo by Pavel Danilyuk via <a href="https://www.pexels.com/photo/a-healthcare-worker-measuring-a-patient-s-blood-pressure-using-a-sphygmomanometer-7108344/" target="_blank" rel="noopener noreferrer" style="color:#1a7abf;">Pexels</a> Photo by Pavel Danilyuk[/caption]

08 Oct

Posted at 17:04h in Heart Disease

Heart Health Notice: If you have chest pain or pressure, shortness of breath, pain spreading to the arm, jaw, neck, or back, cold sweat, nausea, or sudden dizziness, call 911 or your local emergency number right away. Do not drive yourself to the hospital. This article is for general education and does not replace advice from your doctor. Do not start, stop, or change any medication, or begin a new exercise program if you have heart disease or symptoms, without talking to your healthcare provider. Programs, tests, and services mentioned or linked here are not warranted or endorsed by MedicalResearch.com or Eminent Domains Inc.

Many heart attacks seem to come out of nowhere. A person feels fine on Monday and ends up in the hospital on Friday. But the damage usually starts years before. Plaque slowly builds inside the arteries, and most people never feel it happening. The good news is that you can act early. The first step is to know your own risk factors. When you know what puts your heart at risk, you can work with your doctor to address those things before they cause harm. [caption id="attachment_76521" align="aligncenter" width="500"]how-to-help-prevent-heart-attacks-pexels Photo by freestocks.org: [/caption]

06 May

Posted at 18:58h in Nutrition
[caption id="attachment_73606" align="aligncenter" width="500"]adding-fiber-to-diet.jpg Photo by Pexels [/caption]

Please note: Supplements are generally not FDA tested or approved. Some supplements can interfere with medications including blood pressure meds and anticoagulants. Do not delay seeking medical attention for medical concerns by taking supplements without medical advice. Combining supplements can increase the risk of toxicity and side effects. Statements and product contents have not been independently confirmed by MedicalResearch.com or Eminent Domains Inc. Please discuss any and all supplements you take or are considering taking with your health care provider. Ratings in this post are the opinions of the contributing writer and not MedicalResearch.com or Eminent Domains Inc.

Editor's note:  Serious medical conditions, including colon cancer and thyroid disease, can sometimes present with constipation.  Be sure to check with your health care provider or gastroenterologist to discuss your particular medical concerns.

If you struggle with constipation or irregularity, you might wonder if a fiber supplement could help. Most Americans don't get enough fiber from food alone—but does that mean everyone needs a supplement? In this article, we'll break down what fiber supplements are, how different types work, and who might benefit most from adding them to their routine.

06 Sep

Posted at 14:38h in Author Interviews, Heart Disease, JAMA, Primary Care, Stroke, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_59503" align="alignleft" width="150"]Katrina E. Donahue, M.D., M.P.H. Professor and Vice Chair of Research Chapel Hill Department of Family Medicine University of North Carolina Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. Dr. Donahue[/caption] Katrina E. Donahue, M.D., M.P.H. Professor and Vice Chair of Research Chapel Hill Department of Family Medicine University of North Carolina Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease and stroke are the leading causes of death in the U.S. The Task Force found that people who are 40 to 75 years old and at high risk for heart disease should take a statin to help protect their health. People in this age group who are at increased risk but not high risk should make an individual decision with their healthcare professional about whether taking a statin is right for them. There is not enough research to determine whether statins are beneficial for people 76 years and older.

08 Mar

Posted at 18:18h in AHA Journals, Author Interviews, Genetic Research, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_56877" align="alignleft" width="200"]Giordano Bottà, PhD CEO and Co-founder Allelica  The Polygenic Risk Score Company Dr. Bottà[/caption] Giordano Bottà, PhD CEO and Co-founder Allelica The Polygenic Risk Score Company MedicalResearch.com: What is the background for this study? Response: Previous research identified that polygenic risk score (PRS) has the highest predictive power compared to other risk factors and identifies individuals with the same risk of those with familial hypercholesterolemia, but are invisible to traditional risk assessment. We explored for the first time the interplay between the main causes of atherosclerosis, LDL cholesterol and PRS.  We were interested in helping cardiologists understand why some individuals have bad arteries full of plaques while others don't in presence of the same LDL levels and no additional risk factors. Our findings explain why this is the case: LDL does not affect everyone the same. We believe that we are at the forefront of a change of paradigm in cardiovascular risk assessment: LDL levels cannot be accessed without considering the genetics of an individual.

12 Aug

Posted at 21:20h in Author Interviews, Heart Disease, JAMA, Lipids, Metabolic Syndrome, UCSF
MedicalResearch.com Interview with: [caption id="attachment_55111" align="alignleft" width="147"]Prakash Deedwania, MD, FACC,FAHA,FASH,FHFSA,FESC Professor of Medicine, UCSF School of Medicine, San Francisco Dr. Deedwania[/caption] Prakash Deedwania, MD, FACC,FAHA,FASH,FHFSA,FESC Professor of Medicine, UCSF School of Medicine, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: This paper describes the findings form the FOURIER study, a very large study evaluating the efficacy of evolocumab, a PCSK9 inhibitor in patients with metabolic syndrome and preexisting atherosclerotic cardiovascular disease (ASCVD) who were already being treated with statins. In this largest study of its kind of 27,000 patients we found that 60% of patients with ASCVD had metabolic syndrome. We also found that the presence of metabolic syndrome identified a higher risk of future cardiac & coronary events in these patients despite them receiving maximum tolerated doses of statin. Furthermore, study treatment with evolocumab was efficacious in reducing the increased risk during the median follow up of nearly 3 years . Unlike treatment with statins there was no risk of new-onset diabetes with evolocumab, which was generally well tolerated. What was interesting thatpatients without metabolic syndrome had much less benefit with PCSK9 inhibition. These findings suggest that the presence of metabolic syndrome can help the clinicians identify the ASCVD patients who are most likely to benefit from treatment with PCSK9 inhibitors. This will be of great help for the cost containment of therapeutic strategy as PCSK9 inhibitors as a class are still quite expensive drugs.

01 Apr

Posted at 21:27h in Author Interviews, Heart Disease, Lipids
MedicalResearch.com Interview with: [caption id="attachment_53714" align="alignleft" width="172"]Professor F. J. Raal,FRCP, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism, Faculty of Health Sciences, University of the Witwatersrand Professor F. J. Raal[/caption] Professor F. J. Raal, FRCP, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism, Faculty of Health Sciences, University of the Witwatersrand MedicalResearch.com: What is the background for this study? How does Evinacumab differ from the three drugs used in triple therapy for this severe form of hypercholesterolemia? Response:      Despite available lipid lowering therapies, the vast majority of patients with homozygous familial hypercholesterolemia are unable to achieve desirable LDL-cholesterol levels and remain at high risk for premature atherosclerotic cardiovascular disease. Unlike statins and PCSK9-inhibitors which act mainly by upregulating LDL receptor activity on the cell surface, evinacumab, a monoclonal antibody inhibitor of ANGPTL3, acts independent of the LDL receptor.

17 Sep

Posted at 20:22h in AHA Journals, Author Interviews, Heart Disease, Lipids
MedicalResearch.com Interview with: [caption id="attachment_51350" align="alignleft" width="140"]Samuel S. Gidding, MD FH Foundation Pasadena, CA Dr. Gidding[/caption] Samuel S. Gidding, MD FH Foundation Pasadena, CA MedicalResearch.com: What is the background for this study? Response: Patients with familial hypercholesterolemia are at high risk for atherosclerotic heart disease but little is known about intensification of treatment and event rates in lipid specialty care in the United States. We examined data on 1900 patients, enrolled in the CASCADE FH Registry,sponsored by the Familial Hypercholesterolemia Foundation, to determine if cholesterol lowering therapy increased to improve getting patients to a lower LDL cholesterol and to look at incident cardiac events in tow groups, those with prior heart disease and those without.

18 Jul

Posted at 02:12h in Author Interviews, Heart Disease, Lipids
MedicalResearch.com Interview with: [caption id="attachment_50320" align="alignleft" width="150"]Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary Dr. Chen[/caption] Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary  Co-authors: Guanmin Chen, PhD, MD, MPH, Megan S. Farris, MSc, Tara Cowling, MA, MSc, Stephen M. Colgan, PhD, Pin Xiang, PharmD, Louisa Pericleous, PhD, Raina M. Rogoza, MSc, Ming-Hui Tai, MSc, PhD, and Todd Anderson, MD  MedicalResearch.com: What are the main findings? Response:
  • Atherosclerotic cardiovascular disease (ASCVD) remains a significant cause of morbidity and mortality in Canada (and worldwide). Despite the established benefits of treatment with statins, most Canadians fail to achieve dyslipidemia targets (a risk factor for ASCVD).
  • The objective of this study was to examine current treatment patterns of lipid-lowering therapies for the management of low-density lipoprotein cholesterol (LDL-C) in patients with ASCVD.
  • This was a retrospective cohort study conducted using province-wide administrative health data from Alberta, Canada. Datasets used included health services, pharmaceutical, and laboratory data, in addition to the Alberta population registry. The study population consisted of individuals aged 18 years or older diagnosed with ASCVD between 2011-2015, based on International Classification of Diseases (ICD) codes. The cohort was then restricted to individuals with an initial (index) LDL-C measurement after ASCVD diagnosis and at least one year of pre-index data and one year of follow-up data.

30 May

Posted at 15:39h in Author Interviews, Clots - Coagulation, Duke, Genetic Research, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_49440" align="alignleft" width="133"]Thomas J. Povsic, MD, PhDInterventional CardiologistDuke Clinical Research InstituteDuke University School of MedicineDurham, North Carolina  Dr. Povsic[/caption] Thomas J. Povsic, MD, PhD Interventional Cardiologist Duke Clinical Research Institute Duke University School of Medicine Durham, North Carolina  MedicalResearch.com: What is the background for this study?  Response: The background for this study is that it is unknown how mandatory reporting of CYP2C19 metabolizer status affects how doctors treat patients or to what degree provision of this information would affect choice of a P2Y12 inhibitor within a clinical trial. As part of the GEMINI-ACS trial, all patients underwent CYP2C19 metabolizer testing.  This trial enrolled patients with a recent acute coronary syndrome and randomized them to aspirin or a low dose of rivaroxaban.  All patients were also to be treated with ticagrelor or clopidogrel, which was at the discretion of the investigator.  Investigators were given information regarding the CYP2C19 metabolizer status about a week after randomization.  Importantly prior to randomization, all investigators were asked how they expected to use this information, and then we followed what they actually did.

28 May

Posted at 23:10h in Author Interviews, Brigham & Women's - Harvard, JAMA, Lipids
MedicalResearch.com Interview with: [caption id="attachment_49391" align="alignleft" width="133"]Samia Mora, MD, MHSAssociate Physician, Brigham and Women's HospitalAssociate Professor of Medicine, Harvard Medical SchoolBrigham and Women's HospitalDepartment of MedicinePreventive MedicineBoston, MA 02115  Dr. Mora[/caption] Samia Mora, MD, MHS Associate Physician, Brigham and Women's Hospital Associate Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Preventive Medicine Boston, MA 02115  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Lipid testing plays a major role in cardiovascular disease (CVD) risk screening, prediction, and treatment. In the past decade, several pivotal studies (including the Women’s Health Study, the Copenhagen City Heart Study, and the Copenhagen General Population Study) compared populations of individuals who had fasting lipid testing with populations of individuals who had nonfasting lipid testing, and found that non-fasting lipids were at least as good as fasting lipids in cardiovascular risk screening and predicting CVD risk. To date, however, no study has examined the cardiovascular predictive value of lipids measured on the same individuals who had both fasting and nonfasting lipid testing. This is important because individual-level variability in fasting versus nonfasting lipids may not be captured when looking at population-level risk associations, and evidence from randomized studies is lacking. Furthermore, it is unclear whether substituting nonfasting lipids would misclassify cardiovascular risk for individuals who may be eligible for statin therapy.

02 Apr

Posted at 01:31h in Author Interviews, Heart Disease, JAMA, Lipids
MedicalResearch.com Interview with: [caption id="attachment_48314" align="alignleft" width="160"]Victor Wenze Zhong, Ph.D.Postdoctoral fellowDepartment of Preventive MedicineFeinberg School of MedicineNorthwestern University 680 N Lake Shore Dr, Suite 1400Chicago, IL 60611 Dr. Zhong[/caption] Victor Wenze Zhong, Ph.D. Postdoctoral fellow Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago, IL 60611  MedicalResearch.com: What is the background for this study? Response: Dietary cholesterol is a common nutrient in human diet. Eggs, specially egg yolks, are the single richest source of dietary cholesterol among all commonly consumed foods. The associations between dietary cholesterol consumption and cardiovascular disease and mortality remain controversial despite decades of research. Eating less than 300 mg of dietary cholesterol per day was the guideline recommendation before 2015. However, the most recent 2015-2020 Dietary Guidelines for Americans no longer include a daily consumption limit for dietary cholesterol and recommend weekly egg consumption as part of the healthy US-style eating pattern. Whether these recommendations are appropriate have been intensely debated.

02 Jan

Posted at 17:48h in Annals Internal Medicine, Author Interviews, Beth Israel Deaconess, Cost of Health Care, Heart Disease, Lipids
MedicalResearch.com Interview with: [caption id="attachment_46753" align="alignleft" width="150"]Dhruv S. Kazi, MD, MSc, MS Associate Directo Richard A. and Susan F. Smith Center for Outcomes Research Boston MA 02215 Associate Director Cardiac Critical Care Unit Beth Israel Deaconess Medical Center Dr. Kazi[/caption] Dhruv S. Kazi, MD, MSc, MS Associate Director Richard A. and Susan F. Smith Center for Outcomes Research Boston MA 02215 Associate Director Cardiac Critical Care Unit Beth Israel Deaconess Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The ODYSSEY Outcomes trial found that addition of alirocumab to statin therapy reduces the incidence of a composite of cardiovascular death, myocardial infarction, and stroke among patients with a recent history of a myocardial infarction and elevated low-density lipoprotein cholesterol. We modeled the cost-effectiveness of alirocumab and found that, at the March 2018 price of the drug, it would not be cost-effective (either relative to statin alone or statin + ezetimibe) for this indication. We found that a large price-reduction would be required to meet the cost-effectiveness threshold of $100,000 per quality-adjusted life year. Shortly after the preliminary findings of this study were released, both manufacturers of PCSK9 inhibitors announced large price reductions in order to improve access to these drugs.

20 Sep

Posted at 19:48h in Author Interviews, Diabetes, Heart Disease, JAMA, Lipids
MedicalResearch.com Interview with: [caption id="attachment_44601" align="alignleft" width="150"]Luca A. Lotta, MD, PhD Senior Clinical Investigator MRC Epidemiology Unit University of Cambridge Dr. Lotta[/caption] Luca A. Lotta, MD, PhD Senior Clinical Investigator MRC Epidemiology Unit University of Cambridge MedicalResearch.com: What is the background for this study? What are the main findings?
  • Drugs that enhance the breakdown of circulating triglycerides by activating lipoprotein lipase (LPL) are in pre-clinical or early-clinical development.
  • It is not known if these drugs will reduce heart attacks or diabetes risk when added to the current first line therapies (statins and other cholesterol-lowering agents).
  • Studying this would require large randomised controlled trials, which are expensive (millions of GBPs) and time-consuming (years).
  • Human genetic data can be used to provide supportive evidence of whether this therapy is likely to be effective by “simulating” a randomised controlled trial.
  • Our study used naturally occurring genetic variants in the general population (study of ~400,000 people) to address this.
  • Individuals with naturally-lower cholesterol due to their genetic makeup were used as model for cholesterol-lowering therapies (eg. Statins).
  • Individuals with naturally-lower triglycerides due to genetic variants in the LPL gene were used as model for these new triglyceride-lowering therapies.
  • We studied the risk of heart attacks and type 2 diabetes in people in different groups.

14 Jun

Posted at 11:22h in Author Interviews, Heart Disease, Lipids, Statins
MedicalResearch.com Interview with: [caption id="attachment_42382" align="alignleft" width="200"]Fatima Rodriguez, MD, MPH Division of Cardiovascular Medicine Stanford University Stanford, CA 94305-5406, Dr. Rodriguez[/caption] Fatima Rodriguez, MD, MPH Division of Cardiovascular Medicine Stanford University Stanford, CA 94305-5406, MedicalResearch.com: What is the background for this study? What are the main findings? Response: Individuals with LDL-cholesterol levels above 190mg/dL are often underdiagnosed and undertreated, yet remain at high-risk of cardiovascular disease. In a national sample of veterans, we identified over 60,000 patients who met criteria for uncontrolled, severe hypercholesterolemia based on an index LDL-C value ≥190mg/dL. We found that only half of these high-risk patients are being treated with statins, and less than 10% are on high-intensity statin therapy as recommended by the 2013 ACC/AHA guidelines. We also found that both older and younger patients were less likely to be treated with statins. Women were less likely to be treated with statins, whereas minority groups and those with a diagnosis of hypertension were more likely to be treated. Disparities in use of statins were also noted by geographic region and hospital teaching status.

14 Jan

Posted at 14:52h in Annals Internal Medicine, Author Interviews, Heart Disease, Lipids
MedicalResearch.com Interview with: [caption id="attachment_39282" align="alignleft" width="132"]Borge G. Nordestgaard, Borge G. Nordestgaard[/caption] Børge G. Nordestgaard, MD, DMSc Department of Clinical Biochemistry Herlev and Gentofte Hospital, Copenhagen University Hospital Herlev, Denmark MedicalResearch.com: What is the background for this study? Response: Five major organizations recently published guidelines for using statins to prevent atherosclerotic cardiovascular disease  -- the American College of Cardiology/American Heart Association (ACC/AHA) in 2013, the United Kingdom’s National Institute for Health and Care Excellence (NICE) in 2014, and in 2016 the Canadian Cardiovascular Society (CCS), the US Preventive Services Task Force (USPSTF), and the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS). We applied these five guidelines to a contemporary study cohort of 45,750 40-75 year olds from the Copenhagen General Population Study.

15 Dec

Posted at 00:03h in Author Interviews, BMJ, Lipids, Nutrition, Pediatrics, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_38942" align="alignleft" width="200"]Dr. Angela S Donin Population Health Research Institute, St George’s University of London, London, UK Dr. Donin[/caption] Dr. Angela S Donin Population Health Research Institute, St George’s University of London, London, UK  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are increasing numbers of takeaway outlets, particularly in deprived neighbourhoods. This is driving an increase in consumption of takeaway meals, which previous evidence has shown is linked to higher risks of heart disease, type 2 diabetes and obesity. Little is known about the dietary and health impact of high consumption of takeaway foods in children. This research found children who regularly ate takeaway meals had higher body fat and cholesterol compared to children who rarely ate take away meals, they also had overall poorer diet quality.

29 Nov

Posted at 15:46h in Author Interviews, Heart Disease, Lipids, Sanofi
MedicalResearch.com Interview with: [caption id="attachment_38586" align="alignleft" width="143"]Dr. Jay Edelberg VP Head of CV Development and Head Global CV Medical Affairs Dr. Edelberg[/caption] Dr. Jay Edelberg MD, PhD VP Head of CV Development and Head Global CV Medical Affairs Sanofi  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with heterozygous familial hypercholesterolemia (HeFH) are often not able to achieve their target low-density lipoprotein cholesterol (LDL-C) levels, and some may require lipoprotein apheresis (LA) to lower their “bad cholesterol.” Apheresis is a procedure similar to kidney dialysis, where bad cholesterol is mechanically removed from the blood. It is an invasive, expensive, and time-consuming treatment for patients, as well as physicians. The Phase III ESCAPE clinical study looked at the potential effect of LA on total Praluent, free and total PCSK9 concentrations, as well as the combined pharmacodynamics effect of total Praluent on LDL-C-lowering. Praluent levels remained unaffected by apheresis, and Praluent consistently suppressed free PCSK9 levels in patients with HeFH, regardless of LA treatment. This analysis further confirms clinical ESCAPE data that Praluent can be used in conjunction with LA and may reduce or potentially eliminate the need for LA in some patients.

19 Nov

Posted at 20:42h in Author Interviews, Brigham & Women's - Harvard, Lipids
MedicalResearch.com Interview with: [caption id="attachment_38369" align="alignleft" width="125"]Gokhan S. Hotamisligil MD PhD Dr. Hotamisligil[/caption] Gokhan S. Hotamisligil MD PhD J.S. Simmons Professor of Genetics and Metabolism Chair, Department of Genetics and Complex Diseases Department of Genetics and Complex Diseases Department of Nutrition Harvard Stem Cell Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cholesterol is often considered a ‘bad’ nutrient, as it has been strongly linked to a cluster of metabolic diseases. In reality however, cholesterol is absolutely vital for the health of all animal cells, serves as an essential building block for all membranes and precursor for essential molecules.  It usually only becomes toxic when cells are exposed to high levels or free forms of cholesterol or when it is stored in excess. The reasons why cholesterol over-accumulates or causes excessive damage in cells of some people is not entirely clear, as cells are normally should be able to remove such excesses, and there remains key mechanistic gaps in our understanding of how cells control the molecular process of sensing excess cholesterol, engage ways of removal and launch countermeasures to defend their integrity. Filling this gap may reveal a new path toward alleviating the burden of cholesterol-related diseases. To this end, we identified a new signal pathway mediated by a protein called Nrf1, which enables cells to know when to remove cholesterol, thereby preventing excess cholesterol storage. We show that Nrf1 directly senses cholesterol in a strategic subcellular compartment called the endoplasmic reticulum and coordinates an adaptive and defensive responses that protects the cells and promotes the removal of cellular cholesterol.

12 Jun

Posted at 20:55h in Author Interviews, Biomarkers, Heart Disease, Lipids
MedicalResearch.com Interview with: Amane Harada, PhD Senior Researcher Central Research Laboratories, Sysmex Corporation Kobe, Japan Ryuji Toh, MD, PhD Associate Professor Division of Evidence-based Laboratory Medicine Kobe University Graduate School of MedicineRyuji Toh, MD, PhD Associate Professor Division of Evidence-based Laboratory Medicine Kobe University Graduate School of Medicine Kobe, Japan  MedicalResearch.com: What is the background for this study? Response: High-density lipoprotein (HDL) exhibits a variety of anti-atherogenic functions including anti-inflammatory and anti-oxidative functions as well as promoting reverse cholesterol transport. However, it has been reported that HDL may lose its anti-atherogenic properties and become “dysfunctional” HDL under pathological conditions. Recent studies have demonstrated that cholesterol efflux capacity of HDL is a better predictor of CVD than HDL-C, suggesting that not only the quantity, but also the quality of HDL may significantly modulate and predict the progression of cardiovascular disease. However, the conventional procedure for efflux capacity assay requires radiolabeling and cells, and the procedures are time consuming. Therefore, its clinical application is impractical. To solve those problems, we have recently developed a new assay system to evaluate the capacity of HDL to accept cholesterol, named “uptake capacity”.

25 Dec

Posted at 21:04h in Author Interviews, Electronic Records, Genetic Research, Heart Disease, Lipids, Science
MedicalResearch.com Interview with: [caption id="attachment_30763" align="alignleft" width="133"]Michael F. Murray MD Geisinger Health System Danville, PA 17822 Dr. Michael Murray[/caption] Michael F. Murray MD Geisinger Health System Danville, PA 17822 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The DiscovEHR cohort was formed as a result of a research collaboration between Geisinger Health System and Regeneron Pharmaceuticals. There are over 50,000 patient participants in the cohort who have volunteered to have their de-identified genomic sequence data linked to their de-identified EHR data for research purposes. We report in this paper findings around the identification of 229 individuals (1:256) with pathogenic or likely pathogenic variants in one of the three genes (LDLR, APOB, PCSK9) associated with Familial Hypercholesterolemia (FH). The study found that these individuals are unlikely to carry a diagnosis of FH and are at risk for early coronary artery disease.

02 Dec

Posted at 14:15h in Author Interviews, CDC, JAMA, Lipids, Nutrition
MedicalResearch.com Interview with: Asher Rosinger, PHD, MPH Epidemic Intelligence Service Officer, Centers for Disease Control and Prevention Division of Health and Examination Nutrition Examination Surveys, Analysis Branch National Center for Health Statistic MedicalResearch.com: What is the background for this study? Response: Total cholesterol, triglycerides, and low-density lipoprotein (LDL) levels are linked to coronary heart disease and cardiovascular events. Between 1999 and 2010, total cholesterol, triglycerides, and LDL levels declined among U.S. adults. We used new data from the 2011-2014 nationally representative National Health and Nutrition Examination Survey (NHANES) to determine if earlier trends continued.

16 Oct

Posted at 13:23h in Author Interviews, BMJ, Lipids
[caption id="attachment_18498" align="alignleft" width="164"]Jamie Gaida, PhD Assistant Professor Discipline of Physiotherapy University of Canberra Dr. Jamie Gaida[/caption] MedicalResearch.com Interview with: Jamie Gaida, PhD Assistant Professor Discipline of Physiotherapy University of Canberra Medical Research: What is the background for this study? What are the main findings? Dr. Gaida: Cholesterol is essential for life but having too much circulating in your blood increases cardiovascular disease risk. A growing collection of evidence indicates that metabolic health (i.e. cholesterol and diabetes) is linked to musculoskeletal injuries. Tendons connect muscle to bone, and tendinopathy is condition where a person feels pain when using their tendons. People with Achilles tendinopathy experience pain when walking or when running, which limits their ability to be physically active. Tendinopathy also affects other tendons throughout the body, such as the rotator cuff tendons of the shoulder. This research identified all published research on the link between cholesterol levels and tendinopathy. We used a statistical technique called meta-analysis to combine these studies, which showed that cholesterol levels are linked to tendinopathy. However, the most interesting finding was that the pattern of cholesterol changes seen with tendinopathy matched the pattern of cholesterol changes that increase cardiovascular disease risk. It seems that what is bad for you heart is bad for your tendons.

29 Oct

Posted at 02:30h in Author Interviews, Heart Disease, JAMA, Lipids
MedicalResearch.com Interview with: George Thanassoulis, MD MSc FRCP(C) Director, Preventive and Genomic Cardiology FRQ-S Clinician-Scientist/Chercheur-Boursier Clinicien Assistant Professor of Medicine, McGill University McGill University Health Center Montreal, QC Medical Research: What is the background for this study? What are the main findings? Dr. Thanassoulis: Although LDL-C (i.e. bad cholesterol) has been linked with aortic valve disease in several prior reports, randomized trials to lower cholesterol in aortic valve disease were not effective suggesting that cholesterol may not be important in valve disease. To address this, we performed a Mendelian randomization study, that showed that a genetic predisposition to LDL-C, was associated with both calcium deposits on the aortic valve and aortic stenosis (I.e. Valve narrowing).  These results can be viewed as the effect of a life-long increase in LDL-C on the incidence of aortic valve disease and suggest that increases in LDL-C cause aortic stenosis.  

02 Oct

Posted at 22:04h in Author Interviews, General Medicine, Lancet, Lipids
Professor F. J. Raal FRCP, FRCPC, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism Faculty of Health Sciences, University of the Witwatersrand Johannesburg Hospital Johannesburg South AfricaMedicalResearch.com Interview with: Professor F. J. Raal FRCP, FRCPC, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism Faculty of Health Sciences, University of the Witwatersrand Johannesburg Hospital Johannesburg South Africa Medical Research: What are the main findings of the study? Dr. Raal: Heterozygous familial hypercholesterolaemia (HeFH)  is one of the most common inherited disorder in man affects between 1:250 to 1:300 persons worldwide. Thus, there are likely more than 3 million patients with heterozygous familial hypercholesterolaemia in the United States and Europe alone. The RUTHERFORD-2 study was a large world-wide multinational study  of the use of the PCSK9-inhibitor, evolocumab, in over 300 patients with heterozygous familial hypercholesterolaemia (HeFH). Evolocumab administered either 140 mg biweekly or 420 mg monthly as a subcutaneous injection, much like an insulin injection, was well tolerated with minimal side effects,  and markedly reduced levels of LDL cholesterol or “bad cholesterol”  by over 60% compared to placebo.

19 Aug

Posted at 10:02h in Author Interviews, Diabetes, Diabetologia, Heart Disease, Lipids
MedicalResearch.com Interview with: Prof. Michael d’Emden Endocrine Research Unit Royal Brisbane Hospital, Brisbane, Australia Medical Research: What are the main findings of the study? Prof. d’Emden: Our study is the largest trial of women having type 2 diabetes assessing the role of a fibric acid derivative, in this case fenofibrate, ever conducted.  There were 3657 female subjects randomized to placebo or fenofibrate.  The study demonstrated greater reductions in women of total cholesterol, triglycerides and LDL-cholesterol and greater increases in HDL-cholesterol.  In women, fenofibrate decreased total cardiovascular end-points by 30% compared with only 13% in men, although there was no-treatment-by-sex interaction.  The majority of end points assessed revealed a consistent trend to increased benefit being seen in women.

17 Jul

Posted at 01:52h in Author Interviews, Heart Disease, Lipids, NEJM
Professor Jane Armitage Professor of Clinical Trials and Epidemiology Clinical Trial Service Unit, Oxford Cardiovascular Science Oxford, United KingdomMedicalResearch.com Interview with: Professor Jane Armitage Professor of Clinical Trials and Epidemiology Clinical Trial Service Unit, Oxford Cardiovascular Science Oxford, United Kingdom Medical Research: What are the main findings of the study? Prof. Armitage: The study showed that adding extended release niacin with laropiprant (to reduce the flushing) to standard treatment including statins in people with heart disease or strokes did not improve their outcome or reduce the risk of recurrent heart attacks or strokes.

14 May

Posted at 15:48h in Author Interviews, JAMA, Statins
Medidr_jennifer_robinsoncalResearch.com Interview with: Jennifer G. Robinson, MD, MPH Professor ,Departments of Epidemiology & Medicine Director, Prevention Intervention Center Department of Epidemiology College of Public Health University of Iowa Iowa City, IA 52242-2007 MedicalResearch: What are the main findings of the study? Dr. Robinson: The PCSK9 antibody, evolocumab, reduced LDL (or bad) cholesterol by about 65-70% regardless of the dose or type of statin used. This is a greater percentage reduction than ezetimibe, another drug used to lower LDL cholesterol in statin-treated patients, which lowered LDL cholesterol 15-20%. Side effects of evolocumab were similar to those for ezetimibe or placebo.