The Net Guide: Hyperlipidemia

MDNG Primary Care, August 2010, Volume 12, Issue 8

Access a collection of resources on hyperlipidemia for you and your patients.

//The Educated Patient

American Heart Association — Hyperlipidemia

The AHA site for hyperlipidemia begins by explaining what the condition is, followed by a breakdown of the five major families of blood lipoproteins. An explanation of the monitoring cholesterol and how high cholesterol can often be tied to difference between hyperlipoproteinemia, hypercholesterolemia, and hypertriglyceridemia is provided, followed by a list of related AHA publications on these topics. In addition to those AHA publications, the hyperlipidemia page also provides links to educational websites on other topics that are geared toward patients, such as cholesterol, metabolic syndrome, and triglycerides.

Managing Cholesterol: An Interactive Health Tutorial

This module about cholesterol, developed by MedlinePlus, is available as a multimedia tutorial, with questions, as a self-running presentation, or as a downloadable PDF file. The module provides an overview of cholesterol and discusses the causes of high cholesterol and how the condition is diagnosed. The information about treatment options begins by providing general guidelines for other conditions, such as diabetes and thyroid problems. The treatment section also discusses how medication and dietary changes can be used to manage high cholesterol.

//Medical Websites

Screening and Management of Lipids

The three major recommendations discussed in this guideline, which was put together by the National Guideline Clearninghouse (NGC), focus on primary prevention, secondary prevention, and cost effectiveness. Topics covered within both prevention sections include screening, risk, and treatment. Cost effectiveness focuses on the medications that are both effective for treating hyperlipidemia and inexpensive, relative to other treatment options. The NGC includes numerical and alphabetical grading systems that judge the strength of the various recommendations, which physicians can use as an additional tool for judging the value of the guidelines.

National Lipid Association

The NLA prominently features four resources on their homepage, grouped together toward the bottom of the site, that physicians will find particularly helpful. The ReachMD program Lipid Luminations is a series of podcasts that review recent conferences, news updates, and treatment guidelines, and the link to theheart.org gives physicians a preview of what they can find there, with links to recent news stories and study findings. This central spot for resources also showcases papers from the Journal of Clinical Lipidology, the journal of the NLA, and recent chatter from the NLA forum, with links to particular conversations that the NLA has chosen to highlight. The NLA website also features CME activities, patient education resources, and details about upcoming meetings and conferences.

//Clinical Trials

A Study of Nutraceutical Drinks for Cholesterol

Study Type:Interventional

Age/Gender Requirements:20-80 years (male/female)

Sponsor:Healthy Drink Discoveries, Inc.

Purpose:To determine if a drink supplemented with red yeast rice, niacin, phytosterol esters, L-Carnitine, vitamin C, and Co-Q-10 helps to reduce cholesterol levels.

Effects of Amino Acids on Regional Lipid Metabolism

Study Type:Interventional

Age/Gender Requirements:60-75 years (male/female)

Sponsor:The University of Texas, Galveston

Purpose:To determine the effect that amino acids have on treating elevated fat levels in the blood, and to understand how the treatment works.

//eAbstracts

Hyperlipidemia and Primary Prevention of Stroke: Does Risk Factor Identification and Reduction Really Work?

Journal:Current Atherosclerosis Reports(July 2010)

Authors:Lewis A, Segal A

Purpose:To determine if the guidelines and treatment options for hyperlipidemia, a major risk factor for stroke, have helped to reduce the incidence of stroke.

Results:Despite lipid screening guidelines from the United States Preventive Service Task Force, statin medications, and lifestyle modifications — all geared toward treating hyperlipidemia — “there are numerous barriers to maintaining adequate control of lipids.”

//Online CME

Hyperlipidemia

Credits:1.00

Fee:$25.00

Expires:February 1, 2011

Multimedia:Not Listed

This activity reviews hyperlipidemia as defined by the American Heart Association: “an elevation of lipids in the bloodstream.” The program should enable participants to “recognize common lipid disorder syndromes in general internal medicine and family practice clinics” and “describe the principles of managing common lipid disorders.”

Management of Hyperlipidemia

Credits:2.00

Fee:$40.00

Expires:May 14, 2013

Multimedia:Not Listed

This course reviews current guidelines for patients with a variety of lipid disorders, as “abnormalities in lipid metabolism contribute to increased risk for developing coronary heart disease and other forms of vascular disease.” Topics in this CME program include primary and secondary prevention, the importance of vascular inflammation in coronary heart disease, and dyslipidemia. Clinical learning objectives state that the program should allow participants to review the management of hypercholesterolemia, mixed dislipidemia, low HDL, and metabolic syndrome.

From the HCPLive Network

Gastric Bypass Surgery for Patients with HyperlipidemiaIn a University of Iowa study, extremely obese patients who had this surgery experienced a significant reduction in their cholesterol levels within 6 months of surgery, and overall lipid profiles continue to improve for as long as 6 years after the procedure.

Low-carbohydrate Diet Increase Levels of Low-density LipoproteinsLow-carbohydrate diets significantly increase levels of low-density lipoproteins (LDL), and individuals on low-carbohydrate diets do not lose more weight than people eating diets that are high in carbohydrates, a study from the University of Colorado at Denver reveals.

Pharma Focus

Livalo (Pitavastatin)

//eAbstracts

Atherosclerosis Induced by Chronic Inhibition of the Synthesis of Nitric Oxide in Moderately Hypercholesterolaemic Rabbits Is Suppressed by Pitavastatin

Journal:British Journal of Pharmacology(March 2010)

Authors:Kitahara M, Kanaki T, Saito Y

Purpose:To determine if pitavastatin effectively reduces atherosclerotic regions in moderately hypercholesterolemic rabbits.

Results:When atherosclerosis was induced by chronic inhibition of itric oxide synthase (NOS), pitavastatin effectively suppressed atherosclerosis “via inhibition of macrophage accumulation and macrophage foam cell formation.”

Long-term Treatment with Pitavastatin Is Effective and Well-tolerated By Patients with Primary Hypercholesterolemia or Combined Dyslipidemia

Journal:Atherosclerosis(May 2010)

Authors:Ose L, Budinski D, Hounslow N, et al.

Purpose:To determine the safety and tolerability of pitavastatin (4 mg once daily) during 52 weeks of treatment, and to assess the the effect on lipid and lipoprotein fractions and ratios, and LDL-C target attainment.

Results:Pitavastatin was effective and well tolerated by patients with primary hypercholesterolemia or combined dyslipidemia. Additionally, about three-quarters of patients “achieved NCEP and EAS LDL-C targets at week 52, and HDL-C levels rose continually during follow up, while changes in other efficacy parameters were sustained over the year-long study.”

Pitavastatin (Livalo) for Hyperlipidemia and Mixed Dyslipidemia: A Novel Therapeutic Agent, or a ‘Me-Too’ Drug?

Journal:Pharmacy and Therapeutics(April 2010)

Authors:Reilly T, King G, Park J, et al.

Purpose:To review the use of pitavastatin for the treatment of hyperlipidemia by examining “the available data from clinical trials as well as other information relevant to clinical practice.”

Results:In studies against other drugs in its class, pitavastatin has demonstrated high potency and has been shown to significantly reduce atherosclerotic plaque volumes. However, the researchers caution that, “because the 20-mg dose of atorvastatin was a poor comparator, pitavastatin should not replace standard therapy after ACS.”