Effect of Dietary Lipids on the Gut Microbiome: What Do We Know?

After watching the webcast you will be automatically forwarded to the evaluation to earn your CME credits.

Speaker Name/Credentials

Angela Zivkovic, PhD
UC Davis Department of Nutrition, Davis, CA

Estimated Time of Talk

30 minutes

CME Accreditation

30 min webcast = 0.50 credits
15 min Q&A = 0.25 credits
Total = 0.75 credits

Description

This webinar will cover how dietary fat influences the microbiome and how in turn this can have effects on immune and metabolic function.

Learning Objectives

  1. Learn how fat in the diet influences composition of the microbiome
  2. Understand the health benefits of microbiome fermentation
  3. Review dietary components that can shift the microbiome and influence health

Disclosures

None

This enduring material activity, Effect of Dietary Lipids on the Gut Microbiome: What Do We Know?, has been reviewed and is acceptable for up to 0.75 prescribed credits by the American Academy of Family Physicians. Term of approval begins October 3, 2017. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Metabolic Basis of CVD Prevention

After watching the webcast you will be automatically forwarded to the evaluation to earn your CME credits.

Speaker Name/Credentials

Robert H. Eckel, M.D.
Professor of Medicine, Professor of Physiology and Biophysics, Charles A. Boettcher II Chair in Atherosclerosis, University of Colorado Anschutz Medical Campus, Aurora, CO

Estimated Time of Talk

45 minutes

CME Accreditation

45 min webcast = 0.75 credits
15 min Q&A = 0.25 credits
Total = 1.00 credits

Description

This webinar will cover steps to prevent cardiovascular disease by addressing metabolic risk.

Learning Objectives

  1. Learn how metabolic factors contribute to risk of cardiovascular disease.
  2. Review lifestyle and diet considerations that reduce metabolic risk.
  3. Understand treatment strategies and goals for managing metabolic risk factors to reduce cardiovascular disease.

Disclosures

Consultant – Merck, Novo Nordisk, Grants/Fellowships – UniQure Inc., Medical Education – Cardiometabolic Health Congress, IMNE, MedIntelligence, Medscape, Medical Education Resources

This enduring material activity, Metabolic Basis of CVD Prevention, has been reviewed and is acceptable for up to 1.00 prescribed credits by the American Academy of Family Physicians. Term of approval begins October 3, 2017. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Identifying Subclinical Cardiovascular Disease

After watching the webcast you will be automatically forwarded to the evaluation to earn your CME credits.

Speaker Name/Credentials

Gina Pritchard, MSN, RN, CNS, ACNP
The PREVENT! Clinic, Plano, TX – Owner/Nurse Practitioner

Estimated Time of Talk

45 minutes

CME Accreditation

45 min webcast = 0.75 credits
15 min Q&A = 0.25 credits
Total = 1.00 credits

Description

This webinar will cover current imaging methods that diagnose cardiovascular disease and biomarkers for the identification of cardiovascular disease.

Learning Objectives

  1. Understand and compare current imaging methodologies to diagnose cardiovascular disease.
  2. Understand methods that identify subclinical cardiovascular disease.
  3. To explore methods combining results of subclinical disease with biological testing to diagnose and treat patients to prevent disease progression.

Disclosures

Speaker – Bale/Doneen Method, Bale/Doneen Practice; Speaker – Cleveland HeartLab

This enduring material activity, Identifying Subclinical Cardiovascular Disease, has been reviewed and is acceptable for up to 1.00 prescribed credits by the American Academy of Family Physicians. Term of approval begins October 3, 2017. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Aspirin Effectiveness and its Influence on Cardiovascular Risk

After watching the webcast you will be automatically forwarded to the evaluation to earn your CME credits.

Speaker Name/Credentials

Jeffrey Boone, M.D.
Founder and Director of the Boone Heart Institute

Estimated Time of Talk

45 minutes

CME Accreditation

45 min webcast = 0.75 credits
15 min Q&A = 0.25 credits
Total = 1.00 credits

Description

This webinar will cover clinical implications and therapeutic approaches to patients who are poor responders to aspirin therapy.

Learning Objectives

  1. Learn how aspirin therapy reduces cardiovascular events.
  2. Review how 11-dhTXB2 levels can indicate aspirin effectiveness.
  3. Therapeutic considerations and additional testing for those who are poor responders to aspirin therapy.

Conflicts of Interest

Speaker- Amgen, Aralez, Cleveland HeartLab

This enduring material activity, Aspirin Effectiveness and its Influence on Cardiovascular Risk, has been reviewed and is acceptable for up to 1.00 prescribed credits by the American Academy of Family Physicians. Term of approval begins May 1, 2017. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Reducing Cardiovascular Risk in the Patient with Elevated Triglycerides

After watching the webcast you will be automatically forwarded to the evaluation to earn your CME credits.

Speaker Name/Credentials

Alan S. Brown, M.D.
Director, Division of Cardiology and the Lipid Clinic Advocate Lutheran General Hospital
Clinical Associate Professor, Loyola University Medical Center

Estimated Time of Talk

45 minutes

CME Accreditation

45 min webcast = 0.75 credits
15 min Q&A = 0.25 credits
Total = 1.00 credits

Description

This webinar will cover clinical implications and therapeutic approaches to patients with hypertriglyceridemia.

Learning Objectives

  1. Understand the effect of hypertriglyceridemia on CHD risk.
  2. Review treatment strategies to reduce risk of pancreatitis and CHD events.
  3. Review appropriate therapies for patients with elevated triglycerides.

Conflicts of Interest

Speaker- Amgen, Regeneron, Sanofi, Advisory Board- Amarin, Kastle, Kowa, Pfizer, Sanofi

This enduring material activity, Reducing Cardiovascular Risk in the Patient with Elevated Triglycerides, has been reviewed and is acceptable for up to 1.00 prescribed credits by the American Academy of Family Physicians. Term of approval begins May 1, 2017. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Cardiovascular Health in Menopausal Women

Understanding the Critical Triad of Aging, Hormones, and Inflammation

After watching the webcast you will be automatically forwarded to the evaluation to earn your CME credits.

Speaker Name/Credentials

Felice L. Gersh, M.D.
Medical Director, Integrative Medical Group of Irvine Faculty, Fellowship in integrative Medicine University of Arizona School of Medicine

Estimated Time of Talk

45 minutes

CME Accreditation

45 min webcast = 0.75 credits
15 min Q&A = 0.25 credits
Total = 1.00 credits

Description

This webinar will cover the clinical management of hormones to improve cardiovascular health in women.

Learning Objectives

  1. Understand how estrogen can influence many functions of the body that are not directly linked to reproduction.
  2. Understand estrogens role as a master of metabolic homeostasis and regulator of cardiovascular health.
  3. Understand how the loss of estrogen in menopausal women effects cardiovascular health and how to appropriately implement a plan to maintain optimal cardiovascular health.

Conflicts of Interest

Speaker/Consultant – Pure Encapsulations, Speaker/Consultant – Genova Diagnostic Lab, Speaker – L Nutra, Speaker/Consultant – Cleveland HeartLab

This enduring material activity, Cardiovascular Health in Menopausal Women: Understanding the Critical Triad of Aging, Hormones, and Inflammation, has been reviewed and is acceptable for up to 1.00 Prescribed credits by the American Academy of Family Physicians. Term of approval begins May 1, 2017. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Prevention of Heart Attacks and Strokes: A Disease-Inflammatory Approach

The Prevention of Heart Attacks and Strokes: A Disease-Inflammatory Approach

Speaker Name/Credentials

Amy L. Doneen, DNP, ARNP
Medical Director – Heart Attack & Stroke Prevention Center, Co-Founder – Bale/Doneen Method, Adjunct Professor – Texas Tech University Health Sciences
Spokane, WA

Estimated time of Talk

30 minutes

Description

This webinar will cover imaging modalities and biomarkers for the identification of cardiovascular disease.

Learning Objectives

  • Understand the techniques to assess for the presence of subclinical atherosclerosis.
  • Understand event reality and the general concept of atherosclerosis and vascular inflammation.
  • Understand the various root causes associated with the development of vascular inflammation and atherosclerosis.

Conflicts of Interest

Consultant – Cleveland HeartLab

Consultant – MyGenetics

Practical Aspects of Managing Obesity and Hypogonadism in Men

Practical Aspects of Managing Obesity and Hypogonadism in Men

Speaker Name/Credentials

Steven Lamm, MD
Clinical Professor and Medical Director, The Preston Robert Tisch Center for Men’s Health, NYU Langone Medical Center
New York, NY

Estimated time of Talk

30 minutes

Description

This webinar will cover clinical management of obesity and hypogonadism in Men.

Learning Objectives

  • Understand how to diagnose hypogonadism.
  • Understand the impact of obesity on sexual function.
  • Understand the bidirectional relationship between obesity and hypogonadism.

Conflicts of Interest

Speaker – AVEED
Speaker – ENDO
Speaker – Takeda

Women’s Health and Hormones: A Functional Approach

Women’s Health and Hormones: A Functional Approach

Speaker Name/Credentials

Filomena Trindade, MD, MPH, AAARM, ABFM
Private Practice, Capitola, CA

Estimated time of Talk

30 minutes

Description

This webinar will cover symptoms and underlying causes of hormonal imbalance in women.

Learning Objectives

  • Understand insulin’s role in peri-menopause and/or menopause.
  • Understand symptoms and diagnosis associated with high or low cortisol.
  • Understand the relationship between sex hormones and the adrenal and thyroid glands.
  • Understand the estrogen metabolism in peri-menopause/menopausal period.
  • Understand symptoms and their cause(s) common in peri-menopause/menopausal women.

Conflicts of Interest

None

“The Good Cholesterol” May Not be so Good After All

Remember when we used to tell patients that high-density lipoprotein cholesterol (HDL-C) was “healthy” of the “highly desirable lipoprotein”? Well, a number of research studies in recent years have caused cardiovascular and lipid experts to say that the information obtained about HDL via epidemiology led us in the wrong direction.

One pharmaceutical company lost almost a billion dollars when it’s trial of a cholesterol ester transfer protein (CETP) inhibitor more than doubled HDL-C but patients in the treatment group had a higher death rate, so the trial was halted early as raising HDL-C failed to provide benefit.  Other clinical trials that used niacin, which significantly increases HDL-C but doesn’t significantly increase HDL particle number, failed to improve cardiovascular clinical outcomes. This in turn led authors of the American College of Cardiology (ACC) not to recommend niacin in the March 2016 clinical guidelines regarding the role of non-statin therapies in the management of cardiovascular risk.

A more recent study by Sharif and colleagues published in the May issue of Diabetes Care sought to find out if low HDL-C was a risk factor for cardiovascular disease and mortality in subjects with type 2 diabetes mellitus. They also wanted to find out if low HDL-C would remain a residual risk factor in those on intensive lipid-lowering therapy and/or if LDL-C goals were met.

Data was obtained from a cohort (n=1829) of subjects with diabetes enrolled in the Second Manifestations of ARTerial Disease (SMART) trial.  LDL-C levels were stratified into three groups: <77 mg/dL, 77-97 mg/dL, and >97 mg/dL and the intensity of their lipid-lowering therapy. Adjustments were made relating to confounding variables such as BMI, gender, age, triglycerides, LDL-C, HbA1c, glucose, estimated glomerular filtration rate,  alcohol, and smoking.  During the (median) 7 years of follow-up, there were 335 new cardiovascular events and 385 deaths. The investigators found no relationship between HDL-C levels and cardiovascular events. In fact, in their conclusion they stated that they unexpectedly found that subjects with Diabetes and LDL-C levels <77 mg/dL and higher HDL-C at baseline had an increased risk of cardiovascular events and all-cause mortality.

So… gone are the days when we can simply say that HDL is “good”. Experts continue to marvel at the recent discoveries related to the complexity of the proteomics and lipidomics of HDL cholesterol.  In order to prevent events, we need to move beyond HDL-C measurements. Research is currently underway to help us understand how HDL functions and how we can better identify those who are at a higher cardiovascular risk based on HDL functionality rather than on the amount of cholesterol found in the HDL particle.

Pharmacological Principles of Treating Type 1 Diabetes Mellitus

Pharmacological Principles of Treating Type 1 Diabetes Mellitus

Speaker Name/Credentials

Blair Geho, MD, PhD
Adjunct Professor and Chief Translational Officer
Case Western Reserve University School of Medicine 

Learning Objectives

  • Review of normal insulin physiology
  • Review of glucose metabolism in type 1 diabetes: Correction of common misunderstandings
  • Strategies to correct deficiencies of current insulin therapy of type 1 diabetes mellitus

Conflicts of Interest

Founder, Chief Scientific Officer and member of the Board of Directors at Diasome Pharmaceuticals, Inc.

A Primer in Fatty Acids: Why We Need to Understand Fish Oil

A Primer in Fatty Acids: Why We Need to Understand Fish Oil

Speaker Name/Credentials

Seth Baum, MD, FACC, FAHA, FACPM, FNLA
President-Elect, American Society for Preventive Cardiology
Medical Director, Women’s Preventive Cardiology
Christine E. Lynn Women’s Health & Wellness Institute
Boca Raton Regional Hospital
Co-Founder and Chief Medical Officer
MB Clinical Research

Estimated time of Talk

45 minutes

Learning Objectives

  • Define the common fats and fatty acids
  • Understand EPA, DHA, and their derivatives
  • Examine the flaws in Omega-3 CVD Intervention Trials
  • Learn to read a label
  • Understand omega-3 testing and why it makes a difference to test our patients

Conflicts of Interest

AstraZeneca Research/Consultant/Speaker
Regeneron/Sanofi Research
Akcea Research/Consultant
Formulated VitalOils1000TM
Wife owns VitalRemedyMD, Inc.

New Concepts in the Diagnosis and Treatment of Hypertension: The Role of Endothelial Function, Vascular Biology, Nitric Oxide, ADMA and SDMA

New Concepts in the Diagnosis and Treatment of Hypertension

Speaker Name/Credentials

Mark Houston, MD, MS, MSc, ABAARM, FACP, FAHA, FASH, FACN, FAARM
Director, Hypertension Institute and Vascular Biology
Saint Thomas West Hospital
Nashville, TN

For more information about Dr. Houston, please visit:
http://hypertensioninstitute.com/doctor/dr-mark-houston/

Estimated time of Talk

45 minutes

Learning Objectives

  • Understand the pathogenesis of hypertension and Endothelial Dysfunction
  • Review the role of vascular biology, three finite vascular responses (inflammation, oxidative stress and vascular immune function), plasma renin activity (PRA) and aldosterone to select optimal integrative anti-hypertensive therapy to reduce BP and decrease CVD.
  • Review the role of Nitric Oxide, ADMA and SDMA in hypertension and CVD
  • Review diagnostic testing for hypertension: 24 hour ambulatory BP (ABM), endothelial function and arterial compliance testing.
  • Be able to prioritize and personalize the most important nutritional, nutraceutical supplements and life style treatments for hypertension

Conflicts of Interest

Dr. Houston is an independent contractor/consultant for Biotics Research, Spectracell, Designs for Health, Thorne, Vibrant America Labs, Cleveland HeartLab and AC Grace and he is on the review panel/board for Designs for Health, Thorne, Boston Heart Lab, Itamar and receives grants from private industry from Biotics, Thorne and Neogenis.

Stress in the Amygdala, Cardiovascular Risk, and Inflammation

Although psychological stress has been linked to cardiovascular disease risk for years, our understanding of the connection continues to grow.  Dr. Ahmad Tawakol and colleagues at Massachusetts General Hospital in Boston presented information at the 2016 American College of Cardiology sessions from a study they did in 293 patients who had PET/CT scans between 2005 and 2008.  Subjects who had evidence of cancer, established cardiovascular disease or who were younger than age 30 were excluded.  This first-of-kind study revealed a relationship between amygdala activity in the brain, associated with stress and fear, and arterial inflammation.  In addition to objective measurements of brain activity, the scans allowed for measurements in arteries and bone marrow.  Over approximately a 5 year study period and after correction for cardiovascular risk factors based on Framingham Risk and age and gender, investigators found that 35% of the subjects in the high amygdala activity group had a cardiovascular event, whereas only 5% in the low amygdala activity group suffered such.  Dr. Tawakol proposed that perhaps the activation of the amygdala, bone marrow, and arterial inflammation together contribute to a mechanism that may lead to cardiovascular events.  In his concluding remarks, Dr. Tawakol stated that the risk of heart disease linked to stress is on par with other major risk factors.   Further studies are needed, but perhaps those of us interested in the prevention of cardiovascular events might want to evaluate inflammatory biomarkers in our patients who are under stress in an effort to uncover hidden risk and/or subclinical cardiovascular disease.

See: Signs of Stress in the Brain May Signal Future Heart Trouble …

Should we add Migraine Headaches to the CV Risk Factor List?

A recent prospective study based on data from 115,541 women free of known cardiovascular disease (CVD) who were enrolled in the Nurses’ Health Study II was published in the British Medical Journal.  The researchers sought to determine if there was a link between migraine headaches and incident CVD and CVD mortality in women.  Of the subjects enrolled, 15.2% (n=17,531) had physician diagnosed migraine headaches.  Subjects with diagnosed migraines ranged in age from 25-42 years and were followed for over 20 years with a cumulative follow-up rate >90%.  Despite adjustment for potential confounders, migraine headaches were strongly associated with incident stroke (hazard ratio 1.62, 1.37 – 1.92), coronary revascularization procedures/angina (1.73, 1.20 – 2.32), myocardial infarction (1.39, 1.18 to 1.64) and CVD mortality (1.37, 1.02 – 2.32).  These associations held across various subgroups of women by age (<50/≥50 years) and whether or not they had hypertension or were on oral contraceptives or post-menopausal hormone replacement therapy.

The investigators concluded that there was a strong consistent link between CVD events, including CVD mortality, and migraine headaches and recommended that women with migraine headaches be more aggressively evaluated for vascular risk (and subclinical disease.)

Study Shows Colchicine Use in Patients with Gout May Reduce Cardiovascular Event Rates

It is well known that cardiovascular event rates are higher in patients with various inflammatory conditions. A recent study by Dr. Daniel Solomon and colleagues at Harvard revealed an apparent link between large reductions in cardiovascular events in 501 patients with gout who used colchicine over a 16.5 month period vs. 501 similar patients with gout who did not use colchicine. Read more Study Shows Colchicine Use in Patients with Gout May Reduce Cardiovascular Event Rates

Are Lipid Targets Back?

The 2013 American College of Cardiology/American Heart Association (ACC/AHA) Cholesterol Guidelines, based solely on a limited number of randomized controlled clinical trials with statin therapies, recommended reductions of LDL-cholesterol (LDL-C) by >50% or 30-50% for various populations based on trial data and clinical outcomes.  The authors of the document stated they were “not for or against targets” ….but not including guidelines with cholesterol targets or goals led to confusion and controversy amongst experts, clinicians, and patients. Read more Are Lipid Targets Back?

DHEA and Testosterone: The Forgotten Hormones of Menopause

 Tara Scott Forgotten Hormones of Menopause

Speaker Name / Credentials

Tara Scott, MD, FACOG, CNMP, ABAARM
Chief Medical Officer, Revitalize Medical Group
Akron, OH

Estimated time of Talk

45 minutes

Description

This webinar will review the physiology and current literature around DHEA and testosterone.

Learning Objectives

  • Review women’s hormones and their functions
  • Review the history of hormone replacement
  • Discuss the androgens DHEA and testosterone, their functions and benefits to the body
  • Discuss current literature regarding these androgens

Disclosures

Independent Consultant/ Speaker, LP3 Network
Speaker, Metagenics
Speaker, Vertical Pharmaceuticals

Diabesity and Insulin Resistance from a Functional Medicine Perspective

Filomena Trindade Insulin Resistance

Speaker Name / Credentials

Filomena Trindade, MD, MPH
Private practice Capitola, CA

Estimated time of Talk

45 minutes

Description

This webinar will cover root causes of insulin resistance with special focus on how to identify it early and appropriate interventions.

Learning Objectives

  • Understand diabesity and insulin resistance and its contributors
  • Identify what symptoms to look for in a patient’s history and what questions to ask
  • Identify clinical signs of insulin resistance
  • Understand the continuum of insulin resistance
  • Identify laboratory measures to diagnose insulin resistance
  • Understand how to intervene early to reverse insulin resistance or keep it from progressing

Disclosures

Member of Genova Diagnostics speakers Bureau.

The Human Microbiome in Health and Disease

Robert Rountree The Human Microbiome

Speaker Name / Credentials

Robert Rountree, MD
Boulder Wellcare
Boulder, CO

Estimated time of Talk

55 minutes

Description

This webinar will review the health impacts of the human gut microbiome.

Learning Objectives

  • Review the composition of the human microbiome
  • Learn the functions of the microbial metagenome
  • Discuss the role of diet and environmental factors on microbial diversity and composition
  • Explore the impact of alterations in the microbiome on human health

Disclosures

Independent contractor/consultant/speaker for Thorne Research, Albion Laboratories, Genova Diagnostics.

New Study Shows Portfolio Diet Lowers BP (in addition to LDL-C & hsCRP)

Dr. David Jenkins and colleagues have now shown that a variation of the Portfolio Diet (viscous fiber, soy protein, plant sterols, and almonds) proven to lower LDL-C and hsCRP in 2003, also lowers blood pressure (BP). Previous studies had alluded to this potential benefit, so Jenkins et al. looked at pooled data from a study that compared a DASH-type diet to intensive application of the portfolio diet in 241 hyperlipidemic subjects. Read more New Study Shows Portfolio Diet Lowers BP (in addition to LDL-C & hsCRP)

Recent Study Shows Nutraceuticals Improve Abnormal LDL-C

Since statins are often discontinued due to tolerability problems, a study of dyslipidemic patients (n=100) post percutaneous coronary intervention by Marazzi and colleagues published in the Journal of the American College of Cardiology sought to determine the value of a combination of nutraceuticals (policosanol, folic acid, red yeast rice, berberine, astaxanthin and coenzyme Q10) called Armolipid Plus, with or without ezetimibe in getting these patients’ low-density lipoprotein cholesterol (LDL-C) <100 mg/dL. Read more Recent Study Shows Nutraceuticals Improve Abnormal LDL-C

TMAO

TMAO

Gut microbes live symbiotically within the human digestive tract and play important roles in host defense, immunity, and nutrient processing and absorption. This diverse community is unique to each person and influenced by both acute and chronic dietary exposures to various food sources. Nutrients such as phosphatidylcholine (also known as lecithin), choline, and L-carnitine are abundant in animal-derived products such as red meat, egg yolk and full-fat dairy products. When consumed, these nutrients are processed by gut bacteria resulting in the release of various metabolites including TMA (trimethylamine) into the blood. TMA is then transported to the liver where it is converted into TMAO (trimethylamine N-oxide) which has been shown to regulate various physiological processes involved in the development of atherosclerosis.

Learn More

New Research Reveals the Hazards of a Southern Dietary Pattern

According to recently published research in the journal Circulation, Shikany and colleagues sought to find out if the risk of acute coronary heart disease (CHD) was associated with dietary patterns. The Reasons for Geographic and Racial Differences in Stroke (REGARDS) trial data base (n=17,418) was used.  Subjects were enrolled in this national, population-based trial that was conducted in both white and black adults between 2003 and 2007. Read more New Research Reveals the Hazards of a Southern Dietary Pattern

Nonobstructive CAD, Women, and Prevention of Cardiovascular Events

Cardiologists are acknowledging the need to better refine cardiovascular risk assessment in women.  According to information recently published in the Journal of the American College of Cardiology, women are more likely to have nonobstructive coronary artery disease (CAD) than men.  Since nonobstructive CAD, characterized by soft plaque, is known to precede plaque rupture that can lead to devastating cardiovascular events, there is reason for practitioners to pay attention to these gender differences. Read more Nonobstructive CAD, Women, and Prevention of Cardiovascular Events

Study Associates Chronic Dysglycemia (HbA1c ≥ 5.8%) with Inflammation, Endothelial Dysfunction, and Higher Cardiovascular Event Rates post STEMI

Many prevention specialists believe that we are not diagnosing diabetes early enough if we wait for hemoglobin A1c (HbA1c) levels to reach ≥ 6.5%.  Filepe Moura and colleagues sought to find out if there was a relationship between HbA1c  levels in non-diabetic ST-elevation myocardial infarction (STEMI) patients and recurrent cardiac events.  Read more Study Associates Chronic Dysglycemia (HbA1c ≥ 5.8%) with Inflammation, Endothelial Dysfunction, and Higher Cardiovascular Event Rates post STEMI

Does the Mediterranean Diet Also Reduce Risk of Heart Failure and Stroke?

Although the Mediterranean Diet is recommended to help reduce the incidence and mortality of cardiovascular disease in general, data on how it affects heart failure and stroke rates is lacking. In a population-based cohort in Sweden, investigators questioned 32,921 women via dietary questionnaires.  Read more Does the Mediterranean Diet Also Reduce Risk of Heart Failure and Stroke?

New Evidence about the Role of Inflammation in Promoting Coronary Atherosclerosis

A recent study published in the journal Atherosclerosis involved investigating epicardial adipose tissue (EAT) pathology, as determined by neoangiogenesis and inflammation, and atherosclerosis in the coronary arteries as determined by computed tomography (CT) imaging. Read more New Evidence about the Role of Inflammation in Promoting Coronary Atherosclerosis

Is Now the Time to Target Both LDL and Inflammation?

According to the Expert Opinion of Peter Libby, MD, internationally renowned for his work in cardiovascular disease research and just published in the journal Cardiology, “In an era of precision medicine, the ability to target either LDL or inflammation, or both, depending on an individual’s biomarker profile, should allow us to personalize therapy in the secondary prevention of coronary heart disease.” Read more Is Now the Time to Target Both LDL and Inflammation?

Analysis Reveals Lipoprotein “little a” [Lp(a)] Independently Predicts Stroke

According to a study published recently in the journal Atherosclerosis, Lipoprotein (a) is a risk factor for ischemic stroke.  The meta-analysis conducted by Alexander Nave, et. al., reviewed data from 20 articles (studies that did not differentiate between hemorrhagic and ischemic stroke were excluded) that included 90,904 subjects and 5029 stroke events. Read more Analysis Reveals Lipoprotein “little a” [Lp(a)] Independently Predicts Stroke

Study Shows Increased Systemic Inflammation Linked to Risk of Recurrent Heart Attack

It is well known that those who have just had a heart attack are at highest risk for future events.  The “culprit” lesion for the event, may not, however be the only one lurking in the near term, just the only one exposed at the moment.  A recent study published in the Journal of the American Heart Association was designed to investigate systemic atherosclerotic acceleration in relation to the acute inflammatory response surrounding acute myocardial infarction (MI).  Read more Study Shows Increased Systemic Inflammation Linked to Risk of Recurrent Heart Attack

“Treat to Target” BP Study Halted Early Due to Reductions in CV Event and Death Rates

According to officials at the National Institutes of Health (NIH), the Systolic Blood Pressure Intervention Trial (SPRINT) was stopped early due to a stunning improvement in cardiovascular outcomes in the group treated to a target systolic blood pressure (BP) of 120 mm Hg as compared to the “standard of care” control group treated to <140 mm Hg.  Read more “Treat to Target” BP Study Halted Early Due to Reductions in CV Event and Death Rates

Dietary Adjuncts and Cardiovascular Disease Risk Reduction

Kevin Maki Dietary Adjuncts

Speaker Name / Credentials

Kevin C. Maki, PhD, CLS, FNLA, FTOS, FACN
Midwest Center for Metabolic & Cardiovascular Research, Chicago, Illinois

Estimated time of Talk

45 minutes

Description

This webinar will review the National Lipid Association recommendations for dietary modifications intended to lower levels of atherogenic cholesterol [low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C)], with an emphasis on dietary adjuncts to a diet low in saturated fats, trans fats, and cholesterol.

Learning Objectives

  • Review lipids and lipoproteins and their relationship to atherosclerotic cardiovascular disease (ASCVD) risk.
  • Discuss genetic variants associated with altered lipoprotein profiles and their relationships to ASCVD risk.
  • Discuss how dietary adjuncts, with or without pharmacological intervention, work to lower levels of LDL-C and non-HDL-C.
  • Review the effects of a combining a “portfolio” of dietary strategies on circulating levels of atherogenic cholesterol.

Disclosures

Dr. Maki is on the scientific advisory board or has consulted for AstraZeneca, Pharmavite, Matinas BioPharma, Sancilio & Co., National Dairy Council, Egg Nutrition Center, and National Cattlemen’s Beef Association and has received research grants from DuPont, AstraZeneca, AbbVie, ACH Foods, Matinas BioPharma, Shaklee, Egg Nutrition Center, National Dairy Council, National Cattlemen’s Beef Association and Sancilio & Co.

Vascular Inflammation and Nitric Oxide: Bridging Diagnostics to Personalized Therapies

 Nathan Bryan Vascular Inflammation and NO

Speaker Name / Credentials

Nathan S. Bryan, Ph.D.
Baylor College of Medicine, Houston, TX

Estimated time of Talk

45 minutes

Description

This webinar will cover the importance of nitric oxide in vascular inflammation and how it relates to specific diagnostics.

Learning Objectives

  • Explain the regulation of vascular and systemic NO production
  • Describe the link between inflammation and NO
  • Reveal novel strategies to replete NO production and suppress inflammation

Disclosures

Co-Founder and Chief Science Officer, Neogenis Labs, Inc.

An Integrative Medicine Approach to the Management of Cardiometabolic Disease

Joseph Lamb Cardiometabolic Disease

Speaker Name / Credentials

Joseph J. Lamb, MD
Hypertension Institute and Vascular Biology
Saint Thomas Hospital, Nashville, TN

Estimated time of Talk

45 minutes

Description

This webinar will cover nutritional and lifestyle approaches to insulin resistance and cardiometabolic disease.

Learning Objectives

  • Participants should be able to recognize the physiologic connections between environment (nutritional and lifestyle choices) and gene expression as an influence upon phenotypic expression of insulin resistance and cardiometabolic disease.
  • Participants should be able to recommend nutritional and lifestyle medicine approaches in a personalized, evidence-based approach for insulin resistance and cardiometabolic disease.
  • Participants should be able to understand use of phytonutrients, medical foods, and lifestyle change programs as nutritional support for relevant chronic diseases.

Disclosures

Consultant for Nature’s Sunshine Products, Stockholder in KinDex Pharmaceuticals, LLC.

ADMA/SDMA to Assess Endothelial Health

Mark Houston ADMA/SDMA

Speaker Name / Credentials

Mark Houston, MD, MS, MSc, ABAARM, FACP, FAHA, FASH, FACN, FAARM
Hypertension Institute of Nashville, Nashville, TN

Estimated time of Talk

30 minutes

Description

This webinar will cover the role of ADMA/SDMA in the assessment of endothelial health.

Learning Objectives

  • Understand the role of ADMA and SDMA in vascular disease and renal dysfunction.
  • Understand the role of vascular biology in atherosclerosis vascular disease, CHD and CVD.
  • Understand the role of endothelial dysfunction and nitric oxide in CVD.
  • Understand how inflammation, oxidative stress and vascular immune dysfunction promote CVD and CHD.

Disclosures

Independent contractor/consultant/speaker/researcher for Itamar, Biotics Research, Spectracell, BHL, CHL, CardioDX, Neogenis, Designs for Health, Thorne and AC Grace.

ADMA/SDMA

ADMA-SDMAADMA and SDMA may identify endothelial dysfunction due to nitric oxide deficiency. ADMA directly inhibits nitric oxide production and identifies increased risk of cardiovascular disease and adverse events. SDMA indirectly inhibits nitric oxide production and identifies endothelial dysfunction and/or renal insufficiency due to its preferential clearance by the kidneys.

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Are Revolutionary New Drugs on the Horizon to Reduce CV Risks?

What you “need to know” about PCSK9 Inhibitors

Several new drugs that significantly reduce low density lipoprotein (LDL) cholesterol levels have recently been recommended by experts for approval by the Federal Drug Administration (FDA).  Many are optimistic about the approval of alirocumab (suggested trade name Praluent) on July 24th and evolocumab (suggested trade name Repatha) on August 27th.   Read more Are Revolutionary New Drugs on the Horizon to Reduce CV Risks?

Fasting Triglycerides Point to Risk After Acute Coronary Syndrome

A post-hoc analysis of data from two large studies that enrolled subjects post-acute coronary syndrome (ACS) was recently published in the Journal of the American College of Cardiology. Investigators sought to find out if there was a relationship between baseline fasting triglyceride (TG) levels, prior to randomization, and major cardiovascular events. Read more Fasting Triglycerides Point to Risk After Acute Coronary Syndrome

Tame the Flames of PCOS: A Unique Integrative Approach

Felice Gersh Bariatric Surgery

Speaker Name / Credentials

Felice Gersh, MD
Medical Director, Integrative Medical Group of Irvine
Attending Faculty, USC Keck School of Medicine

Estimated time of Talk

30 minutes

Description

This webinar will review polycystic ovary syndrome (PCOS) including how it manifests and how it can be managed.

Learning Objectives

  • Understand the metabolic complexity behind PCOS
  • Identify those who are at risk of PCOS, what the symptoms are, and how to diagnose it
  • Review the current available treatments and those on the horizon
  • Understand how patients can live a ‘normal’ life with PCOS

Disclosures

Dr. Gersh is a consultant and speaker for Cleveland HeartLab, Inc.

Familial Hypercholesterolemia (FH): Underdiagnosed and Undertreated

Seth Baum Familial Hypercholesterolemia

fh-foundation-logo

Speaker Name / Credentials

Seth J. Baum, MD, FACC, FAHA, FACPM, FNLA
Medical Director, Women’s Preventive Cardiology
Christine E. Lynn Women’s Health and Wellness Institute

Estimated time of Talk

45 minutes

Description

This webinar will review the pathophysiology of familial hypercholesterolemia (FH) as well as how to identify it and manage it using current and emerging therapies.

Learning Objectives

  • Review lipids and lipoproteins
  • Discuss FH as a genetic disorder
  • Discuss the pathophysiology of FH and how to screen and diagnose the disorder
  • Review the current management options and emerging therapies for FH

Disclosures

Dr. Baum is on the speaker’s bureau for Genzyme and a consultant for Aegerion, Kowa, and Solstas Lab Partners.

The Power of Sleep: A Key to Addressing Inflammation and Optimizing Health

Param Dedhia The Power of Sleep

Speaker Name / Credentials

Param Dedhia, MD
Director of Sleep Medicine, Canyon Ranch

Estimated time of Talk

30 minutes

Description

This webcast will cover the importance of sleep as it relates to various comorbidities, inflammation and long-term cardiovascular risk.

Learning Objectives

  • Present the power of sleep as a key for optimal health
  • Illuminate the sleep-inflammation connection
  • Offer tips and clinical pearls for best sleep

Disclosures

None

Can Circulating Vitamin D Levels Provide Useful Information about Coronary Artery Disease status?

Research published in Nutrition, Metabolism, and Cardiovascular Diseases examined data from 375 patients undergoing coronary angiography between November 2012 and September 2013. For this study, a diagnosis of coronary artery disease (CAD) was defined as the presence of ≥50% stenosis in at least one major coronary artery. Read more Can Circulating Vitamin D Levels Provide Useful Information about Coronary Artery Disease status?

Myeloperoxidase

MPOMPO is a white blood cell-derived inflammatory enzyme that measures disease activity from the luminal aspect of the arterial wall. Briefly, when the artery wall is damaged, or inflamed, MPO is released by invading white blood cells where it accumulates. MPO mediates the vascular inflammation that propagates plaque formation and activates protease cascades that are linked to plaque vulnerability. White blood cell activation in the bloodstream, in response to luminal injury of the artery wall including fissures, erosions or a degrading collagen cap, leads to MPO release in the bloodstream. This combination of detrimental effects demonstrates that MPO is actively involved in the progression of atherosclerosis.

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F2-Isoprostanes (F2-IsoPs)

F2-IsopsF2-IsoPs, prostaglandin-like compounds formed from the free radical-mediated oxidation of arachidonic acid, are the ‘gold standard’ for measuring oxidative stress in the body. F2-IsoPs also have potent biological effects associated with inflammation and therefore may mediate chronic disease initiation and progression. Additionally, F2-IsoPs may also act as potent vasoconstrictors via thromboxane formation in the endothelium, and promote platelet activation resulting in thrombus formation.

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OxLDL

OxLDLOxLDL measures protein damage due to the oxidative modification of the ApoB subunit on LDL cholesterol. The oxidation of LDL cholesterol is one of the first steps in the development of atherosclerosis. Briefly, LDL-C enters the artery wall where it becomes oxidized. OxLDL is then recognized by scavenger receptors on the macrophages which engulf OxLDL, resulting in foam cell formation, vascular inflammation and the initiation of atherosclerosis.

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Microalbumin

MACRMicroalbumin is the quantification of small amounts of albumin, a serum protein, in urine that can be used to identify microvascular endothelial dysfunction. The presence of small amounts of albumin in the urine may suggest the presence of systemic endothelial dysfunction – an early indicator of heart disease. This test is more sensitive than a standard dipstick test routinely performed in an office setting.

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Lp-PLA2 Activity

Lp-PLA2

Lp-PLA2, or lipoprotein-associated phospholipase-A2, measures disease activity within the artery wall below the collagen or calcified cap due to the activation of macrophages. Lp-PLA2 is not an acute phase reactant. When disease is active in the artery, increased levels of Lp-PLA2 are produced by macrophages and foam cells within the intima of the artery. Lp-PLA2 also interacts with oxidized LDL, which increases inflammation and enhances a proatherogenic state, as well as plaque vulnerability. Research suggests that it plays a direct role in the atherosclerotic disease process.

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CoQ10

CoQ10Coenzyme Q10 (CoQ10) is a fat-soluble, vitamin-like substance present in most cells, primarily in mitochondria. CoQ10 has two major roles within the human body: it participates in aerobic cellular respiration generating energy (i.e., ATP) and is a powerful antioxidant. CoQ10 exists as two forms in the body: ubiquinone and ubiquinol (the active form of CoQ10, which is made from ubiquinone).

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MTHFR

MTHFRMTHFR (5,10-methylenetetrahydrofolate reductase) is an enzyme involved in the metabolism of folate. MTHFR catalyzes the conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, the major circulating form of folate. In turn, 5-methyltetrahydrofolate is involved in the conversion of homocysteine to methionine. MTHFR has an important role in maintaining folate and methionine levels, as well as helping to keep circulating homocysteine levels low. MTHFR is also involved in the methylation pathway, which has multiple, wide-ranging roles in the body, including regulation of gene expression and enzymatic activities.

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CYP2C19

CYP2C19CYP2C19 is a member of the cytochrome P450 family of enzymes involved in the metabolism and bioactivation of drugs. In particular, CYP2C19 is integral for the generation of the active form of clopidogrel (Plavix®), which is prescribed in a prodrug form. This prodrug is converted by CYP2C19 to the active form in the liver. Several variants of CYP2C19 have been identified which have an impact on its ability to metabolize drugs. The main CYP2C19 alleles include the non-functional alleles *2 and *3, as well as the hyperactive *17 allele.

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ApoE

ApoEApoE is an apolipoprotein found in blood that, in association with lipids, forms lipoproteins including very low-density lipoproteins (VLDL). ApoE plays multiple roles in the regulation of lipid and lipoprotein levels in the blood. ApoE serves as a ligand for members of the low-density lipoprotein (LDL) receptor family, and is involved in the removal of lipoproteins from the circulation for excretion in the liver. ApoE is also involved in the formation of chylomicrons and VLDL, and affects the activity of other proteins and enzymes that are involved in lipid metabolism, such as hepatic lipase and lipoprotein lipase.

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Adiponectin

AdiponectinAdiponectin is an abundant hormone released by adipocytes (or fat cells), commonly referred to as an adipokine. Adiponectin plays a large metabolic role in the body, participating in the regulation of glucose levels, insulin sensitivity and lipid catabolism. Adiponectin also helps support proper endothelial functioning and has multiple anti-inflammatory properties, including inhibiting the transformation of macrophages to foam cells, one of the first steps of atherosclerosis.

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OmegaCheck

OmegaCheckOmega-3 and omega-6 fatty acids are polyunsaturated long chain fatty acids (PUFA) required by the body for proper functioning, normal growth and the formation of neural synapses and cellular membranes. Omega-3 and -6 fatty acids are considered “essential” and obtained primarily from dietary sources.

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HDL2b

HDL2bHDL cholesterol, like LDL cholesterol, can be divided into several subfractions, based on density, size and protein composition. The HDL2 subfraction (HDL2a, HDL2b) consists of larger, more buoyant particles while particles in the HDL3 subfraction (HDL3a, HDL3b, HDL3c) are smaller and denser. The largest and most buoyant HDL particle is HDL2b.

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