arrow Log In to View Account     |      
HOME
Johns Hopkins Medicine
Hopkins Logo


Disclaimer: CME certification for these activities has expired. All information is pertinent to the timeframe in which it was released.


Evaluating New Developments for the Clinical Management of High Blood Cholesterol


GOAL
To provide an in-depth analysis of the newly released Adult Treatment Panel III (ATP III) Cholesterol Guidelines, what they dictate as well as the impact they have on cardiologists, internists, primary care physicians, and other health care professionals.

TARGET AUDIENCE
This activity is designed for cardiologists, pharmacists, primary care physicians, nurses, and other health care professionals.

LEARNING OBJECTIVES
After reading this issue, the participant should be able to:

  • Better understand the need for aggressive lipid lowering in diabetes
  • Implement NCEP ATP III guidelines for patients with diabetes and the metabolic syndrome.
  • Develop a symptomatic approach to the combined pharmacologic treatment of diabetic dislipidemia
  • Review the significance of the metabolic syndrome

ACCREDITATION STATEMENT
This activity has been planned and produced in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education. The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

CREDIT DESIGNATION STATEMENT
The Johns Hopkins University School of Medicine designates this continuing medical education activity for a maximum of 1 hour in Category 1 credit toward the American Medical Association Physicians' Recognition Award. Each physician should claim only those hours of credit that are actually spent on the educational activity. Credits are available until the expiration date of June 30, 2004.

This continuing medical education activity was produced under the supervision of Roger S. Blumenthal, MD, Director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease and Peter O. Kwiterovich, Jr, MD, Professor of Medicine and Pediatrics, Johns Hopkins University School of Medicine, and Director of the Johns Hopkins University Lipid Clinic.

This program is approved for 1 hour of credit (0.1 CEUs) and is co-sponsored by The University of Tennessee College of Pharmacy who is approved by the American Council on Pharmaceutical Education as a provider of continuing pharmaceutical education. ACPE Program #064-999-02-222-H01.

This continuing pharmacy education activity was produced under the supervision of Glen E. Farr, PharmD, Assistant Dean of Continuing Education, University of Tennessee College of Pharmacy.

This program is supported by an unrestricted educational grant from Sankyo Pharma.

Publisher's Note and Disclaimer: The opinions expressed in this issue are those of the authors, presenters, and/or panelists and are not attributable to the publisher, editor, advisory board of Advanced Studies in Medicine, or The Johns Hopkins University School of Medicine or its Office of Continuing Medical Education. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this issue are not necessarily the same as indicated in the package insert for the product and may reflect the clinical experience of the authors, presenters, and/or panelists or may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.

Advanced Studies in Medicine (ISSN-1530-3004) is published by Galen Publishing, LLC, an HMG Company. P.O. Box 340, Somerville, NJ 08876. (908) 253-9001. Web site: www.galenpublishing.com. Copyright ©2001 by Galen Publishing, LLC. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. Bulk postage paid at Somerville, NJ Post Office and at additional mailing offices. Advanced Studies in Medicine is a registered trademark of The Healthcare Media Group, LLC. Printed on acid-free paper. BPA Membership applied for December 2000.

PROGRAM CHAIRPERSONS

    Roger S. Blumenthal, MD
    Director of Preventive Cardiology
    The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease
    Johns Hopkins University School of Medicine
    Baltimore, Maryland
    • Dr Blumenthal reports receiving grants and/or research support from Merck, Pfizer, Wyeth-Ayerst, Bristol-Myers Squibb, and Novartis; receiving honoraria from Merck, Pfizer, Medcom, and Physician's World.

    Peter O. Kwiterovich, Jr, MD
    Professor of Medicine and Pediatrics
    Johns Hopkins University School of Medicine
    Director, Johns Hopkins University Lipid Clinic
    Chief, Lipid Research
    Johns Hopkins University Hospital
    Baltimore, Maryland
    • Dr Kwiterovich reports receiving grants and/or research support from AstraZeneca, Merck, Kos, and Pfizer; serving as a consultant and receiving honoraria from Merck, Sankyo Pharma, and Kos.

PARTICIPATING FACULTY

    Sherita Hill Golden, MD, MHS
    Faculty - Endocrinology
    Johns Hopkins University School of Medicine
    Baltimore, Maryland
    • Dr Golden reports receiving grants and/or research support from The Robert Wood Johnson Foundation.

    Howard Knapp, MD, PhD
    Executive Director
    Deaconess Billings Clinic
    Billings, Montana
    • Dr Knapp reports receiving grants and/or research support from Pfizer, Merck, Novartis, Knoll, Amgen, Bayer, Bristol-Myers Squibb, SmithKline Beecham, Pharmacia, Aventis, Wyeth-Ayerst, Schering-Plough, and Sankyo Pharma; receiving honoraria from Roche, Bayer, and Sankyo Pharma.

    William C. Little, MD
    Chief - Cardiology Section
    Wake Forest University Baptist Medical Center
    Winston-Salem, North Carolina
    • Dr Little reports receiving grants and/or research support from Merck; and serving as a consultant for Merck and Sankyo.

    James J. Maciejko, MD, PhD
    Director of Preventive Cardiology
    St. Johns Hospital
    Detroit, Michigan
    • Dr Maciejko reports receiving grants and/or research support from Merck, Pfizer, Beckman-Coulter, and Roche; receiving honoraria from Sankyo Pharma, Pfizer, Merck, Kos, DuPont, and Abbott.

    David G. Robertson, MD
    Assistant Clinical Professor
    Emory University School of Medicine
    Physician - Atlanta Diabetes Association
    Atlanta, Georgia
    • Dr Robertson reports serving as a consultant for Kos, and Abbott; receiving honoraria from Pfizer, Bristol-Myers Squibb, and Sankyo Pharma.

Advanced Studies in Medicine provides disclosure information from contributing authors, lead presenters, and participating faculty. Advanced Studies in Medicine does not provide disclosure information from authors of abstracts and poster presentations. The reader shall be advised that these contributors may or may not maintain financial relationships with pharmaceutical companies.

Cardiovascular disease (CVD) is the leading cause of death in people with diabetes, making the need to manage risk for CVD among these patients as critical as the need to manage their blood glucose levels. Recognition of this fact has prompted the US National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) to elevate diabetes to the status of a coronary heart disease (CHD) risk equivalent and to call for a more intensive prevention strategy for patients with diabetes.

This publication focuses on the management of dyslipidemia and the metabolic syndrome in preventing CHD in patients with diabetes. Based on proceedings of a roundtable symposium of national authorities on cholesterol management that took place in Baltimore, Maryland, on December 4, 200l, it presents an overview of specific ATP III recommendations and their implications for clinical practice.

In an overview of the new guidelines, Sherita Hill Golden, MD, MHS, an endocrinologist on the faculty of Johns Hopkins University, addresses possibilities for successful implementation of risk-reducing practices in patients with diabetes and possibilities for pharmacologic management of cholesterol. She describes the metabolic consequences of insulin resistance and their implications for cardiovascular health. The mechanisms of atherosclerosis, the primary cause of mortality in people with diabetes, are described in detail, as well as the physiological causes of the high incidence of dyslipidemia in this population. Dr Golden also presents clinical evidence supporting aggressive cholesterol management in patients with diabetes and describes the importance of the metabolic syndrome and lifestyle interventions as well as various pharmacologic approaches to cholesterol management.

In the roundtable discussion and case study that follow, several authorities in the field of dyslipidemia discuss current concepts and some of the key issues involved in the diagnosis and treatment of lipid disorders and glucose intolerance in patients with diabetes. The limitations of low-density lipoprotein cholesterol (LDL-C) as a predictor of treatment success in diabetic patients is discussed, along with the clinical challenges in achieving triglyceride and high-density lipoprotein cholesterol (HDL-C) goals within this population. These experts share their knowledge and experience from clinical practice, including views on how best to achieve lipid and triglyceride goals, the role of apolipoprotein B (apo B) in therapeutic decision making, and the implications of emergent research for practicing physicians.

*Director of Preventive Cardiology, The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland.
†Professor of Medicine and Pediatrics, Johns Hopkins University School of Medicine; Director, Johns Hopkins University Lipid Clinic; Chief, Lipid Research, Johns Hopkins University Hospital, Baltimore, Maryland.





Johns Hopkins Advanced Studies in Medicine (ISSN-1558-0334), is published by Galen Publishing, LLC, d/b/a ASiM, PO Box 340, Somerville, NJ 08876. (908) 253-9001. Copyright ©2012 by Galen Publishing. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. ASiM is a registered trademark of The Healthcare Media Group, LLC.