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Articles by Paul N. Hopkins
Total Records ( 3 ) for Paul N. Hopkins
  Susan Huckendubler Stephenson , Stacey Larrinaga-Shum and Paul N. Hopkins
 

Background

Patients with heterozygous familial hypercholesterolemia (FH) patients often have difficultly achieving National Cholesterol Education Program (NCEP) goals. Herein we present an evaluation of a centrally located, nationwide treatment support program that remotely attempted to educate and guide FH patients by monitoring their serum low-density lipoprotein (LDL) cholesterol levels and giving appropriate treatment recommendations through mail contact. All subjects were FH patients registered with the Make Early Diagnosis to Prevent Early Deaths (MEDPED) program.

Methods

In this descriptive evaluation, we compared self-reported lipid levels in 386 FH patients participating in our treatment support program with 295 non-participants who had responded to questionnaires. Participants were recruited into the treatment support program if they had not reached their LDL cholesterol goal after at least 1 year of follow-up and were unable to receive specialized lipid care due to location.

Results

Participants who continued for a longer term in the treatment support program achieved greater total cholesterol reductions (14%) than the comparison group (7%, P=.004). Reductions in total and LDL cholesterol were highly correlated with more aggressive use of statin medications (P <.0001).

Conclusions

These results demonstrate the potential benefits and limitations of a centralized program operating remotely to encourage appropriate treatment of severe hypercholesterolemia.

  Paul N. Hopkins
  Heterozygous familial hypercholesterolemia (FH) is one of the most common serious genetic conditions known. Appropriate treatment is clearly cost-effective, yet public health efforts are minimal in most countries. Despite remarkable progress in understanding of the genetic basis of cardiovascular disease and much talk about personalized medicine, we are still missing huge opportunities to find and help people with FH. Indeed, FH is the only genetic cause of premature CAD for which a systematic, population-based approach to find affected individuals and screen their families is clearly warranted at this time. Finding and helping persons with FH is the mission of the MEDPED program.
  Anne C. Goldberg , Paul N. Hopkins , Peter P. Toth , Christie M. Ballantyne , Daniel J. Rader , Jennifer G. Robinson , Stephen R. Daniels , Samuel S. Gidding , Sarah D. de Ferranti , Matthew K. Ito , Mary P. McGowan , Patrick M. Moriarty , William C. Cromwell , Joyce L. Ross and Paul E. Ziajka
  The familial hypercholesterolemias (FH) are a group of genetic defects resulting in severe elevations of blood cholesterol levels and increased risk of premature coronary heart disease. FH is among the most commonly occurring congenital metabolic disorders. FH is a treatable disease. Aggressive lipid lowering is necessary to achieve the target LDL cholesterol reduction of at least 50% or more. Even greater target LDL cholesterol reductions may be necessary for FH patients who have other CHD risk factors. Despite the prevalence of this disease and the availability of effective treatment options, FH is both underdiagnosed and undertreated, particularly among children. Deficiencies in the diagnosis and treatment of FH indicate the need for greatly increased awareness and understanding of this disease, both on the part of the public and of healthcare practitioners. This document provides recommendations for the screening, diagnosis and treatment of FH in pediatric and adult patients developed by the National Lipid Association Expert Panel on Familial Hypercholesterolemia. This report goes beyond previously published guidelines by providing specific clinical guidance for the primary care clinician and lipid specialist with the goal of improving care of patients with FH and reducing their elevated risk for CHD.
 
 
 
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