LDL-C Lowering in Women and People of Color | Episode Two

From Lab to Life

For CME Information and Credit: www.iridiumce.com/lipidsinwomen

Host:

• Dr. Scott Webb

Guests:

• Dr. Keith C. Ferdinand
  • Gerald S. Berenson Endowed Chair in Preventative Cardiology
  • Professor of Medicine, Tulane University School of Medicine
• Dr. Erin Mikos
  • Director of Women's Cardiovascular Health Research
  • Associate Director of Preventative Cardiology, Johns Hopkins University School of Medicine
  • Co-Editor-in-Chief of The American Journal of Preventative Cardiology

Supported by:

• Independent educational grant from Aspirion

Episode Overview:
This episode focuses on disparities in the management of LDL-C and cardiovascular risk among women and individuals from various racial and ethnic groups. Dr. Ferdinand and Dr. Mikos highlight the importance of LDL-C lowering therapies and strategies clinicians can use to improve treatment outcomes for patients at risk for ASCVD (atherosclerotic cardiovascular disease).

Key Takeaways:

• LDL-C Lowering Treatments and Guidelines:
  • LDL-C is a primary target for preventing ASCVD, with guidelines recommending lower thresholds for high-risk patients.
  • Non-statin therapies such as bempedoic acid, PCSK9 inhibitors, and ezetimibe provide valuable alternatives for patients with statin intolerance.
• Importance of Early and Intensive Treatment:
  • Evidence shows that early LDL-C lowering significantly reduces cardiovascular risk, particularly in high-risk patients, including those with diabetes and ASCVD.
  • Combination therapy should be considered earlier in management to achieve target lipid levels, as is done with hypertension and diabetes treatments.
• Disparities in Care:
  • There are lower rates of optimal hypercholesterolemia management in women and racial/ethnic groups, partly due to healthcare access, physician awareness, and patient adherence.
  • Clinicians should be mindful of sex-specific risk enhancers, such as pregnancy-related conditions, and should address social determinants of health when assessing risk in diverse populations.
• Shared Decision Making and Patient Communication:
  • A shared decision-making approach that includes culturally competent, clear communication and educational materials helps engage patients in their care.
  • Tools such as risk calculators (e.g., the AHA’s PREVENT model) and visual aids can help explain cardiovascular risk and the importance of lowering LDL-C to patients.

Case Discussion:
The episode also features a case study of a 56-year-old Hispanic female with multiple cardiovascular risk factors, including dyslipidemia and diabetes. Dr. Mikos and Dr. Ferdinand discuss the importance of intensifying her lipid-lowering therapy and managing her blood pressure to meet guideline-based targets.

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