Cardiovascular disease remains the leading cause of death in industrialized societies, and the majority of events are related to atherosclerotic cardiovascular disease. However, in contrast to cancer, which is the second leading cause of death, the vast majority of cardiovascular events could be prevented if individuals were identified early in life and if preventive measures, including lifestyle modification and pharmacotherapy, were initiated. During the last quarter of a century, extraordinary developments in the field of preventive cardiology, with tremendous advances in basic science and clinical research in the area of lipids, lipoproteins, and atherosclerosis, have led to continual improvements in clinical practice. This textbook has been written for both practicing clinicians and students who are interested in effective management of lipids for the treatment and prevention of cardiovascular disease.
The textbook has been divided into three major sections: mechanisms, risk assessment, and therapy. Optimal clinical care requires understanding the basic mechanisms involving lipoprotein metabolism, genetics, and atherosclerosis, which are covered in the first section. This fundamental knowledge can be translated into clinical benefits for patients by using a systematic two-step process of screening followed by targeted interventions. The first step involves global risk assessment to identify individuals who have increased risk for developing atherosclerotic cardiovascular events, and the second step is to implement therapeutic interventions targeted to correct metabolic derangements, using both lifestyle modifications and pharmacotherapy to reduce atherothrombotic cardiovascular events. In addition to understanding the current guidelines and how to implement existing therapies optimally, it is important that physicians understand the evolving targets of therapy and in particular the principles and practices required for management of special patient populations who are high risk for atherosclerotic cardiovascular events.This textbook has been developed to be useful for cardiologists, endocrinologists, internists, family practitioners, physician assistants, nurses, pharmacists, and other healthcare professionals who want in-depth, state-of-the-art information on the treatment of lipids and atherosclerosis. We hope that it will serve as an important resource for students and trainees. I was personally motivated to go into the field of cardiovascular disease because my father had a myocardial infarction complicated by ventricular fibrillation when I was in high school, my father's sister died of a myocardial infarction when I was in medical school, and I helped take care of my mother's brother after he suffered a large stroke complicated by expressive aphasia and hemiparesis while I was training as a cardiology fellow. We clearly now have both the knowledge and the therapies to prevent the vast majority of heart attacks and strokes that occur in our patients, and it is my greatest hope that the information in this book will be used in the successful implementation of strategies to manage lipids and other risk factors to prevent pain, suffering, and death from atherosclerotic cardiovascular disease.
Christie M. Ballantyne
Foreword
Links between lipids and cardiovascular disease emerged over the past century based on laboratory experiments and observational data in humans. For more than half a century, physicians have used cholesterol measurements for assessing the risk of future cardiovascular disease. The science of cholesterol has spawned many Nobel prizes and yielded a daunting body of basic science findings. Yet, only in the past two decades have practical tools evolved for clinical intervention on lipids. This recent burgeoning of the evidence base supporting clinical benefit has evolved to the point where most national guidelines recommend therapies that address the lipids profile. This convergence of new clinical tools and clinical trials have garnered the attention of practitioners and spurred the adoption of lipid treatments by practitioners.
Despite this progress the field of lipidology has engendered considerable ongoing controversy, confusion, and frustration. While we have good tools to manipulate low-density lipoprotein (LDL), uncertainty persists regarding how, and how far, to lower this cholesterolcarrying particle. Other prevalent lipid targets such as high-density lipoprotein (HDL) and lipoprotein (a) [Lp(a)] have proved challenging to modulate in clinically practical ways. A number of approaches to modify lipoprotein oxidation and to raise HDL levels have encountered obstacles during their clinical development.
The role of advanced lipid testing in daily practice remains uncertain. An array of tests confronts the practitioner, including lipoprotein particle number, particle size, and apolipoprotein content. How should the practicing physician adopt these specialized tests in the clinic? While many pharmacologic tools exist for manipulating aspects of the lipid profile, some prove challenging to implement in practice due to unwanted actions. Other interventions, although they may produce apparently beneficial effects on the laboratory findings, have proved elusive in terms of defining clinical benefit. So, while on the one hand we have made major advances in treating lipid disorders that undoubtedly help our patients, much opportunity remains for further inroads and the way forward requires considerable clarification.
Where can busy practitioners who want the best possible outcomes for their patients and need to keep abreast of this important, rapidly moving, but challenging field to turn for help? Clinical Lipidology, edited by Dr. Christie Ballantyne as part of the family of companions to Braunwald's Heart Disease, strives to meet this need. This text provides an authoritative and comprehensive but clinically relevent and practical compendium of contemporary lipidology. It spans the scientific foundations through practical applications to common clinical scenarios, and does not sidestep the controversial or unsolved aspects of this field. The authors have also, in the individual contributions, casted a glance to the future to lay the groundwork for rapid uptake of anticipated advances.
The individual chapters by groups of renowned experts and noted teachers provide brief but definitive tools and ready reference to guide physicians in their daily work. A number of chapters deal succinctly but authoritatively with existing and emerging biomarkers relevent to lipidology and cardiovascular risk. The chapters on intervention emphasize those that involve lifestyle change as well as pharmacologic measures. The chapters provide an evidence-based and scholarly, but balanced and accessible, approach to clinical lipidology. The editors of Braunwald's Heart Disease expect this unified approach to fill an important gap to enable the practitioner to diagnosis and manage lipid disorders encountered in daily clinical practice with confidence and expertise.
Links between lipids and cardiovascular disease emerged over the past century based on laboratory experiments and observational data in humans. For more than half a century, physicians have used cholesterol measurements for assessing the risk of future cardiovascular disease. The science of cholesterol has spawned many Nobel prizes and yielded a daunting body of basic science findings. Yet, only in the past two decades have practical tools evolved for clinical intervention on lipids. This recent burgeoning of the evidence base supporting clinical benefit has evolved to the point where most national guidelines recommend therapies that address the lipids profile. This convergence of new clinical tools and clinical trials have garnered the attention of practitioners and spurred the adoption of lipid treatments by practitioners.
Despite this progress the field of lipidology has engendered considerable ongoing controversy, confusion, and frustration. While we have good tools to manipulate low-density lipoprotein (LDL), uncertainty persists regarding how, and how far, to lower this cholesterolcarrying particle. Other prevalent lipid targets such as high-density lipoprotein (HDL) and lipoprotein (a) [Lp(a)] have proved challenging to modulate in clinically practical ways. A number of approaches to modify lipoprotein oxidation and to raise HDL levels have encountered obstacles during their clinical development.
The role of advanced lipid testing in daily practice remains uncertain. An array of tests confronts the practitioner, including lipoprotein particle number, particle size, and apolipoprotein content. How should the practicing physician adopt these specialized tests in the clinic? While many pharmacologic tools exist for manipulating aspects of the lipid profile, some prove challenging to implement in practice due to unwanted actions. Other interventions, although they may produce apparently beneficial effects on the laboratory findings, have proved elusive in terms of defining clinical benefit. So, while on the one hand we have made major advances in treating lipid disorders that undoubtedly help our patients, much opportunity remains for further inroads and the way forward requires considerable clarification.
Where can busy practitioners who want the best possible outcomes for their patients and need to keep abreast of this important, rapidly moving, but challenging field to turn for help? Clinical Lipidology, edited by Dr. Christie Ballantyne as part of the family of companions to Braunwald's Heart Disease, strives to meet this need. This text provides an authoritative and comprehensive but clinically relevent and practical compendium of contemporary lipidology. It spans the scientific foundations through practical applications to common clinical scenarios, and does not sidestep the controversial or unsolved aspects of this field. The authors have also, in the individual contributions, casted a glance to the future to lay the groundwork for rapid uptake of anticipated advances.
The individual chapters by groups of renowned experts and noted teachers provide brief but definitive tools and ready reference to guide physicians in their daily work. A number of chapters deal succinctly but authoritatively with existing and emerging biomarkers relevent to lipidology and cardiovascular risk. The chapters on intervention emphasize those that involve lifestyle change as well as pharmacologic measures. The chapters provide an evidence-based and scholarly, but balanced and accessible, approach to clinical lipidology. The editors of Braunwald's Heart Disease expect this unified approach to fill an important gap to enable the practitioner to diagnosis and manage lipid disorders encountered in daily clinical practice with confidence and expertise.
Peter Libby, Robert O. Bonow, Douglas L. Mann, Douglas P. Zipes, Eugene Braunwald
Key Features
- Features the expertise of one of the foremost experts in the field, ensuring you get authoritative guidance with the most definitive knowledge available.
- Contains extensive clinically relevant information covering risk assessment, therapy, special patient populations, and experimental therapies, including targeting HDL to help you effectively manage any challenges you face.
- Uses treatment algorithms for easy access to key content.
- Presents current practice guidelines that assist in the decision-making process.
Website Features
- Consult the book from any computer at home, in your office, or at any practice location.
- Instantly locate the answers to your clinical questions via a simple search query.
- Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.
SECTION 1 - BASIC MECHANISMS
CHAPTER 1 - Human Plasma Lipoprotein Metabolism
CHAPTER 2 - Regulation and Clearance of Apolipoprotein B–Containing Lipoproteins
CHAPTER 3 - Absorption and Excretion of Cholesterol and Other Sterols
CHAPTER 4 - High-Density Lipoprotein Metabolism
CHAPTER 5 - Lipoproteins: Mechanisms for Atherogenesis and Progression of Atherothrombotic Disease
CHAPTER 6 - Genetic Dyslipidemia
CHAPTER 7 - High-Density Lipoprotein Mutations
CHAPTER 8 - Lipoprotein Oxidation and Modification
SECTION II - RISK ASSESSMENT
CHAPTER 9 - Cholesterol: Concentration, Ratio, and Particle Number
CHAPTER 10 - High-Density Lipoprotein Cholesterol in Coronary Heart Disease Risk Assessment
CHAPTER 11 - Lipoprotein(a)
CHAPTER 12 - Clinical Evaluation for Genetic and Secondary Causes of Dyslipidemia
CHAPTER 13 - Use of High-Sensitivity C-Reactive Protein for Risk Assessment
CHAPTER 14 - Role of Lipoprotein-Associated Phospholipase A2 in Vascular Disease
CHAPTER 15 - Emerging Assays
CHAPTER 16 - Noninvasive Assessments of Atherosclerosis for Risk Stratification
SECTION III - THERAPY
CHAPTER 17 - Overview of General Approach to Management of Elevated Low-Density Lipoprotein Cholesterol and Mixed Dyslipidemia, High Triglycerides, and Low High-Density Lipoprotein Cholesterol
CHAPTER 18 - Treatment Guidelines Overview
CHAPTER 19 - Dietary Patterns for the Prevention and Treatment of Cardiovascular Disease
CHAPTER 20 - Exercise and Lipids
CHAPTER 21 - Weight Loss
CHAPTER 22 - Statins
CHAPTER 23 - Bile Acid Sequestrants
CHAPTER 24 - Cholesterol Absorption Inhibitors
CHAPTER 25 - Nicotinic Acid
CHAPTER 26 - Fibrates
CHAPTER 27 - Omega-3 Fatty Acids
CHAPTER 28 - Endocannabinoid Receptor Blockers
CHAPTER 29 - Combination Therapy for Dyslipidemia
CHAPTER 30 - Low-Density Lipoprotein Apheresis
CHAPTER 31 - Nutriceuticals and Functional Foods for Cholesterol Reduction
CHAPTER 32 - Evolving Targets of Therapy
CHAPTER 33 - Modulation of Biomarkers of Inflammation
CHAPTER 34 - Invasive Imaging Modalities and Atherosclerosis: The Role of Intravascular Ultrasound
CHAPTER 35 - Noninvasive Imaging Modalities and Atherosclerosis: The Role of Ultrasound
CHAPTER 36 - Noninvasive Imaging Modalities and Atherosclerosis: The Role of Magnetic Resonance Imaging and Positron Emission Tomography Imaging
CHAPTER 37 - Special Patient Populations: Diabetes and Metabolic Syndrome
CHAPTER 38 - Special Patient Populations: Women and Elderly
CHAPTER 39 - Special Patient Populations: Acute Coronary Syndromes
CHAPTER 40 - Special Patient Populations: Transplant Recipients
CHAPTER 41 - Special Patient Populations: Chronic Renal Disease
CHAPTER 42 - Special Patient Populations: Lipid Abnormalities in High-Risk Ethnic Groups
CHAPTER 43 - Special Patient Populations: HIV Patients
CHAPTER 44 - Investigational Agents Affecting Atherogenic Lipoproteins
CHAPTER 45 - Therapeutic Targeting of High-Density Lipoprotein Metabolism
CHAPTER 46 - Experimental Therapies of the Vessel Wall
Product Details
- Hardcover: 608 pages
- Publisher: Saunders; Har/Psc edition (2009)
- Language: English
- ISBN-10: 1416054693
- ISBN-13: 978-1416054696
- Product Dimensions: 10.9 x 8.7 x 1.1 inches
List Price: $186.00
Look for These Other Titles in the Braunwald's Heart Disease Family
Braunwald's Heart Disease Companions Series
- Acute Coronary Syndromes by Pierre Theroux
- Atlas of Cardiac Computed Tomography by Allen J. Taylor
- Clinical Lipidology by Christie M. Ballantyne
- Clinical Arrhythmology and Electrophysiology by Ziad Issa, John M. Miller and Douglas P. Zipes
- Heart Failure by Douglas L. Mann
- Preventive Cardiology by Roger S. Blumenthal, Joanne M. Foody and Nathan D. Wong