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Howard Weintraub, MD: Welcome to the HCPLive® Peers and Perspectives® presentation, which is titled “Advances in the Management of Hypercholesterolemia.” I’m Howard Weintraub. I’m a cardiologist. I am a clinical professor of medicine at the NYU Grossman School of Medicine and I’m the clinical director of the NYU Center for the Prevention of Cardiovascular Disease. It is my pleasure to be joined by Dr Alan Brown, who is the director of the division of cardiology at the Advocate Lutheran General Hospital in Park Ridge, Illinois. We’ll be discussing hypercholesterolemia and its management in a variety of patient populations, including consideration of the use of the newer PCSK9 monoclonal antibodies.
Alan, what would you consider to be causes leading to hypercholesterolemia and resulting effects on peoples’ health, namely genetic and environmental?
Alan S. Brown, MD, FACC, FAHA, FNLA: I’m going to steal a line from an old friend of mine, Gregg Fonarow, who says that genetics load the gun and environment pulls the trigger. Most people with dyslipidemia have some underlying genetic predisposition. There are groups where it’s a very clear, single gene as in familial hypercholesterolemia. The majority of the population has more minor genetic abnormalities that lead to elevated cholesterol. As they gain weight or they eat a diet high in saturated fat or cholesterol, you start to see the numbers go up, often after adolescence. Both genetic and environmental factors contribute to dyslipidemia, and we know that leads to the potential for cardiovascular disease, whether it is cerebrovascular coronary disease or peripheral vascular disease.
Transcript Edited for Clarity