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CMHC PULSE

Cardio Metabolic Health Congress – Official Blog

FH: Lifestyle, Luck, or Genetics?

View a Clinical Snapshot from Dr. Pamela Morris on the practical management of familial hypercholesterolemia (FH).

Diabetes Management Update

What is the link between diabetes and Alzheimer’s disease? C. Ronald Kahn, MD will present “Is Alzheimer’s Disease Type 3 Diabetes?” Dr. Kahn will discuss the correlation between the two, the effect of insulin resistance on brain function, and the potential use of antidiabetic medications in Alzheimer’s disease and dementia.

With regard to novel diabetes therapies, according to John B. Buse, MD, PhD, “I suspect that the combination of GLP-1 receptor agonists and basal insulin will become the default pathway of diabetes management in the future; and SGLT-2 inhibitors, as a once-daily oral medication, are compelled to play a central role in diabetes care moving forward.” Dr. Buse will discuss these points further in Type 2 Diabetes Management 2014, followed by Howard Wolpert, MD who will discuss the physiologic and practical considerations of initiating insulin therapy and avoiding the extremes of hyper- and hypoglycemia. Read more

Is There More to CHD Risk than LDL Cholesterol?

Which of the many so called “risk factors” correlated with Coronary Heart Disease (CHD) actually cause disease? According to Dr. Sekar Kathiresan, genetic discoveries are proving crucial to disentangling cause from correlation. Dr. Kathiresan will present the session Is There Anything More to CHD Risk than LDL Cholesterol?” on Thursday, October 23, 2014 at the 9th Annual CMHC.

“Our work to date,” he said, “suggests that there are three lipid fractions that show evidence in terms of a causal relationship: LDL; lipoprotein(a); and triglyceride-rich lipoproteins (TRLs). In contrast, although low levels of HDL are correlated with CHD risk, low HDL levels do not represent a causal relationship.”

“The good news,” Dr. Kathiresan continued, “is that there is something beyond LDL. Naturally occurring genetic mutations in four different genes alter triglycerides and CHD risk. In a recent study, it was found lifelong lower levels of APOC3 caused by a genetic mutation led to a 50% reduced risk of CHD… We’re in an interesting phase, where there’s a resurgence of interest in TRLs. The challenge over the next few years will be in proving that reducing TRLs will not only lower triglycerides but also the risk of CHD.”

The Role of Inflammation

In their Thursday morning keynote address, Drs. Peter Libby and Paul Ridker will also address CHD risk factors beyond lipids by presenting their research on the role of inflammation in the pathophysiology of atherosclerosis and the impact anti-inflammatory therapies under investigation may have on reducing cardiovascular event rates. “The magnitude of independent risk associated with inflammation is at least as large, if not larger, than that of blood pressure and cholesterol,” said Dr. Paul Ridker.

View CMHC highlights – visit CMHC Rewind for featured presentations from the 2014 CMHC.

Familial Hypercholesterolemia Awareness Day is Today

One Minute, One Family
It takes just 1 minute to share vital information that might save a family from early CVD.

“I first found out I had high cholesterol when I was in high school. Without having a name for it, I knew that it was something that I had inherited from my father’s side of the family. I have now accepted the fact that diet and exercise are not enough for what we have. Aggressive medical treatment is necessary.” — Catherine Davis Ahmed, FH Advocate, Director of Outreach, FH Foundation

“It wasn’t until I saw a lipid specialist about my kids that I actually learned about the disease I have. Now that I know what I am fighting against, I am learning everything I can about FH in order to guide my kids through this disease with early detection and appropriate treatment. My wish for them is a future without the intense surgeries that I have had, in order to save my life.”-Scott Radabaugh, Patient Advocate Read more

The Gut Microbiome in Obesity and New FDA Approvals

“Some exciting news in the obesity pharmacotherapy space has occurred, opening up new therapeutic options for an area of metabolic medicine where there remains a great need,” Robert H. Eckel, MD said, referring to last week’s decision by the FDA to approve the obesity drug extended release naltrexone/bupropion (Contrave) and the recommendation by an FDA advisory panel to approve the use of liraglutide, already well known for the treatment of diabetes, in chronically obese patients. In the wake of these announcements, the 2014 CMHC Saturday session and symposia devoted to Lifestyle and Obesity Management are bound to provide much thought-provoking discussion and practical applications for clinicians.

In addition to Dr. Eckel, Caroline M. Apovian, MD will discuss long-term use of obesity medications and sustaining weight loss; Thomas A. Wadden, PhD will present information on behavioral strategies in obesity management; and William E. Kraus, MD will discuss the role of exercise in the modulation of nontraditional CHD risk factors.

Groundbreaking Research
Peter J. Turnbaugh, PhD will discuss his novel research on the impact of gut microbiota on obesity and CVD risk. “Much of what makes us human-many important aspects of our health and predisposition to disease-depends on the metabolic activity of our associated microbes,” he said. Specifically, Dr. Turnbaugh will discuss recent studies implicating gut microbes in obesity, how these interactions are influenced by host and environmental factors, and the potential mechanisms responsible, as well as opportunities for clinical intervention in the coming years.

Rounding out the Obesity day will be Lee M. Kaplan, MD, PhD and Francesco Rubino, MD presenting the latest research and recommendations for bariatric surgery, and Virend K. Somers, PhD addressing the impact of sleep apnea and restricted sleep patterns on cardiometabolic health.

View CMHC highlights – visit CMHC Rewind for featured presentations from the 2014 CMHC.