Advances in the Management of Hypercholesterolemia - Episode 2
Alan S. Brown, MD, FACC, FAHA, FNLA: Howard, I know you have spent a lot of your career dealing with multiple risks for cardiovascular disease—not just lipids but hypertension, cigarette smoking, and other things—as a former board member of the American Society for Preventive Cardiology. I’ve had the pleasure of serving with you on that. Do you want to talk about all the different risk factors that contribute to cardiovascular disease, beyond lipids, and why we need to have a multidisciplinary approach?
Howard Weintraub, MD: That’s a very good question, Alan. It’s fairly obvious that if all you do is focus on 1 risk factor and ignore the blood pressure, diabetes, smoking, obesity, inactivity, and the increasingly important issues of genetics, as you just pointed out, you’re going to have a woefully inadequate response. One of the things that separates us as the preventive cardiologists is that we have to keep our eyes open on the whole horizon and call attention to everything. Those efforts, in my experience, have led to very gratifying results in reducing the severity of atherosclerosis and made a real impact on the likelihood of stroke, MI [myocardial infarction], or severe peripheral vascular disease. You already brought up in our discussion before the meeting that the younger generation may potentially not have as good of a health outlook as their parents. This is related to obesity and the pursuing effects of insulin resistance, metabolic syndrome, and prediabetes, which some people are now talking about. We’re really getting in on this feature. You can’t underestimate the role of multifactor evaluation and really diligent attention. Making it well into your eighth and ninth decades of life without having had stents in your body, stitches on your sternum, or balloons being putting into your femoral artery has a certain degree of merit.
Transcript Edited for Clarity