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The Re-Emergence of Lipoprotein(a) in a Broader Clinical Arena
Lipoprotein(a) [Lp(a)] is a genetic, independent and likely causal risk factor for cardiovascular disease (CVD) and calcific aortic valve stenosis (CAVS). Lp(a) levels are primarily genetically determined and tend to fluctuate only mildly around a pre-determined level. In primary care settings, one Lp(a) measurement can reclassify up to 40% of patients in intermediate risk score categories. In secondary care settings, recent data from the JUPITER and AIM-HIGH trials demonstrate that elevated Lp(a) remains part of the “residual risk” despite achievement of low-density lipoprotein cholesterol levels (Source: Progress in ...
Source: Progress in Cardiovascular Diseases - August 2, 2016 Category: Cardiology Authors: Sotirios Tsimikas Source Type: research

Statin Intolerance: A Literature Review and Management Strategies
Statin intolerance is a commonly encountered clinical problem for which useful management strategies exist. Although many patients report statin-related muscle symptoms, studies indicate that the majority of these patients can tolerate a statin upon re-challenge. Alternative statin dosing strategies are an effective way to modify and reintroduce statin therapy for patients reporting adverse symptoms. Correction of vitamin D deficiency and hypothyroidism may improve statin tolerability in some patients. (Source: Progress in Cardiovascular Diseases)
Source: Progress in Cardiovascular Diseases - August 2, 2016 Category: Cardiology Authors: David R. Saxon, Robert H. Eckel Source Type: research

Cholesterol Guidelines: More Similar Than Different?
A clinician has a large number of guidelines to follow. Searching the words “cardiovascular” and “guideline” on the website, www.guideline.gov yielded 502 cardiovascular guidelines, 40 alone in 2015.National Guideline Clearinghouse: Agency for Healthcare Researcha and Quality. http://www.guideline.gov/search/search.aspx?term=cardiovascular+guidelines. Accessed March 29 (2016) 1 Similarly, searching the words “cholesterol” and “guideline” yielded 107 results, 6 alone in 2015. This information overload can decrease providers' self-efficacy in using guidelines, particularly if they have inconsistent messages. ...
Source: Progress in Cardiovascular Diseases - August 2, 2016 Category: Cardiology Authors: Yashashwi Pokharel, Julia M. Akeroyd, Salim S. Virani Source Type: research

Type III Hyperlipoproteinemia: Still Worth Considering?
Familial type III hyperlipoproteinemia (HLP) was first recognized as a distinct entity over 60 years ago. Since then, it has proven to be instructive in identifying the key role of apolipoprotein E (apoE) in removal of the remnants of very low density lipoproteins and chylomicrons produced by the action of lipoprotein lipase on these triglyceride-transporting lipoproteins. It has additionally shed light on the potent atherogenicity of the remnant lipoproteins. This review describes the history of development of our understanding of type III HLP, discusses the several genetic variants of apoE that play roles in the genesis ...
Source: Progress in Cardiovascular Diseases - July 29, 2016 Category: Cardiology Authors: Conrad B. Blum Source Type: research

Type III hypercholesterolemia: still worth considering?
Familial type III hyperlipoproteinemia (HLP) was first recognized as a distinct entity over 60years ago. Since then, it has proven to be instructive in identifying the key role of apolipoprotein E (apoE) in removal of the remnants of very low density and chylomicrons produced by the action of lipoprotein lipase on these triglyceride-transporting lipoproteins. It has additionally shed light on the potent atherogenicity of the remnant lipoproteins. This review describes the history of development of our understanding of this fascinating disorder, discusses the several genetic variants of apoE that play roles in the genesis o...
Source: Progress in Cardiovascular Diseases - July 29, 2016 Category: Cardiology Authors: Conrad B. Blum Source Type: research

Advances in Lipid Therapy: The Role of Lipid Treatment in Women in Primary Prevention
Cardiovascular disease (CVD) remains the leading cause of death for women. Given the overall prevalence of CVD and its risk factors in women, primary prevention is an important focus. In 2013, the American College of Cardiology and the American Heart Association released guidelines for men and women on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk (ASCVD) in adults based on randomized-controlled trials. Fixed and appropriate intensity of a statin based on calculation of an individual's risk of ASCVD or in diabetics or those with severely elevated low-density lipoprotein cholesterol patien...
Source: Progress in Cardiovascular Diseases - July 29, 2016 Category: Cardiology Authors: Martha Gulati, C. Noel Bairey Merz Source Type: research

Familial Hypercholesterolemia: Advances in Recognition and Therapy
Familial hypercholesterolemia (FH) is an autosomal co-dominant genetic disorder characterized by elevated low-density lipoprotein cholesterol levels and increased risk for premature cardiovascular disease. It is under diagnosed, yet early detection and treatment are critical to limit premature atherosclerotic disease. High-intensity statins are the mainstay of treatment, which should be started as early as possible in homozygous FH and as soon as the diagnosis of heterozygous FH is made in adults. (Source: Progress in Cardiovascular Diseases)
Source: Progress in Cardiovascular Diseases - July 28, 2016 Category: Cardiology Authors: Jacqueline L. Cartier, Anne Carol Goldberg Source Type: research

Hypertension Due to Toxic White Crystals in the Diet: Should We Blame Salt or Sugar?
The “Salt Hypothesis” is the notion that an increase in salt intake will increase blood pressure and thus increase the risk of cardiovascular disease (CVD),which has been a point of contention for decades. Despite this, numerous health organizations, dietary guidelines, and government policies advoc ate population-wide salt restriction. However, there is no conclusive proof that restricting salt intake reduces the risk of hypertension (HTN) and/or CVD events; sodium restriction in fact may paradoxically lead to adverse health outcomes. (Source: Progress in Cardiovascular Diseases)
Source: Progress in Cardiovascular Diseases - July 19, 2016 Category: Cardiology Authors: James J. DiNicolantonio, James H. O'Keefe Source Type: research

Hypertension due to toxic white crystals in the diet: Should We blame salt or sugar?
The “Salt Hypothesis” is the notion that an increase in salt intake will increase blood pressure and thus increase the risk of cardiovascular disease (CVD),which has been a point of contention for decades. Despite this, numerous health organizations, dietary guidelines, and government policies advocate population-wide salt restriction. However, there is no conclusive proof that restricting salt intake reduces the risk of hypertension (HTN) and/or CVD events; sodium restriction in fact may paradoxically lead to adverse health outcomes. (Source: Progress in Cardiovascular Diseases)
Source: Progress in Cardiovascular Diseases - July 19, 2016 Category: Cardiology Authors: James J. DiNicolantonio, James H. O'Keefe Source Type: research

Overcoming Potential Threats to Scientific Advancements: Conflict of Interest, Ulterior Motives, False Innuendos and Harassment
Humanity faces great challenges to public health in the 21st century, including global epidemics of chronic diseases [i.e., noncommunicable diseases (NCDs)] such as obesity, cardiovascular disease, cancers, and type 2 diabetes, as well as environmental and social challenges. The possible solutions to these challenges are quite complex, since they entail many layers of science as well as many layers external to science (e.g., politics, policy, research funding, and public perception) to achieve beneficence. (Source: Progress in Cardiovascular Diseases)
Source: Progress in Cardiovascular Diseases - July 18, 2016 Category: Cardiology Authors: Michael Sagner, Martin Binks, Christos Yapijakis, Carl J. Lavie, Erica Frank, Barry A. Franklin, Daniel E. Forman, Ross Arena, Carlo La Vecchia, Pekka Puska Source Type: research

Treatment of advanced group 2 PH
Pulmonary hypertension (PH) frequently occurs in patients with left heart disease (LHD), including heart failure with reduced and preserved ejection fraction and valvular heart disease. PH in patients with LHD is associated with worse outcomes making it an attractive target of therapy. Despite the strong rational for treatment, no clear benefits from treating with pulmonary arterial hypertension specific therapies in patients with PH from LHD have been found in clinical trials and some studies have demonstrated harm. (Source: Progress in Cardiovascular Diseases)
Source: Progress in Cardiovascular Diseases - July 10, 2016 Category: Cardiology Authors: Christopher F. Barnett, Teresa De Marco Source Type: research

Treatment of Advanced Group 2 PH
Pulmonary hypertension (PH) frequently occurs in patients with left heart disease (LHD), including heart failure with reduced and preserved ejection fraction and valvular heart disease. PH in patients with LHD is associated with worse outcomes making it an attractive target of therapy. Despite the strong rational for treatment, no clear benefits from treating with pulmonary arterial hypertension specific therapies in patients with PH from LHD have been found in clinical trials and some studies have demonstrated harm. (Source: Progress in Cardiovascular Diseases)
Source: Progress in Cardiovascular Diseases - July 10, 2016 Category: Cardiology Authors: Christopher F. Barnett, Teresa De Marco Source Type: research

Epidemiology of Pulmonary Hypertension in Left Heart Disease
Pulmonary hypertension (PH) in the setting of left side heart disease is associated with adverse outcomes. The exact prevalence of PH in the different pathologies that affect the left ventricle, however, is difficult to access with the current literature. The lack of a standard definition of PH in older studies, the different modalities to assess pulmonary artery pressures and the varying disease severity, all account for the great variability in the reported prevalence of PH. PH can accompany heart failure (HF) with reduced (HFrEF) or preserved [1] ejection fraction (HFpEF) as well as mitral and aortic valve disease; in a...
Source: Progress in Cardiovascular Diseases - July 8, 2016 Category: Cardiology Authors: Ashrith Guha, Javier Amione-Guerra, Myung H. Park Source Type: research