Showing papers by "Scott M. Grundy published in 2015"
Emory University1, DePaul University2, University of Miami3, Baylor College of Medicine4, Pennsylvania State University5, University of California, Irvine6, Duke University7, University of Colorado Denver8, Medical University of South Carolina9, University of Oklahoma10, University of Texas Southwestern Medical Center11, University of Illinois at Chicago12, Tulane University13, University of California, San Francisco14, Icahn School of Medicine at Mount Sinai15, Harvard University16, Virginia Commonwealth University17, University of Pennsylvania18, Rush University Medical Center19, Oregon Health & Science University20
TL;DR: This document represents a continuation of the National Lipid Association recommendations developed by a diverse panel of experts who examined the evidence base and provided recommendations regarding the following topics: lifestyle therapies and strategies to improve patient outcomes by increasing adherence and using team-based collaborative care.
690 citations
TL;DR: This document provides support for a consensus set of recommendations for patient-centered management of dyslipidemia in clinical medicine and an elevated level of cholesterol carried by circulating apolipoprotein B-containing lipoproteins is a root cause of atherosclerosis.
610 citations
Emory University1, Icahn School of Medicine at Mount Sinai2, University of Texas Southwestern Medical Center3, Washington University in St. Louis4, Laval University5, Johns Hopkins University School of Medicine6, University of California, San Diego7, American Academy of Pediatrics8, Texas Tech University9, Virginia Commonwealth University10, University of South Carolina11, New York Institute of Technology12, University of Pennsylvania13, American Diabetes Association14, Foundation for Biomedical Research15, University of Missouri–Kansas City16, American College of Cardiology17
TL;DR: The Cardiometabolic Think Tank consensus was that the metabolic syndrome (MetS) is a complex pathophysiological state comprised of a cluster of clinically measured and typically unmeasured risk factors, is progressive in its course, and is associated with serious and extensive comorbidity as mentioned in this paper.
192 citations
TL;DR: There are conflicting data as to whether adipose tissue worsens the metabolic syndrome or protects against it, and many potential connections between adipOSE tissue and metabolic syndrome remain to unravelled.
Abstract: Obesity is strongly associated with metabolic syndrome. Recent research suggests that excess adipose tissue plays an important role in development of the syndrome. On the other hand, persons with a deficiency of adipose tissue (e.g. lipodystrophy) also manifest the metabolic syndrome. In some animal models, expansion of adipose tissue pools mitigates adverse metabolic components (e.g. insulin resistance, hyperglycaemia and dyslipidemia). Hence, there are conflicting data as to whether adipose tissue worsens the metabolic syndrome or protects against it. This conflict may relate partly to locations of adipose tissue pools. For instance, lower body adipose tissue may be protective whereas upper body adipose tissue may promote the syndrome. One view holds that in either case, the accumulation of ectopic fat in muscle and liver is the driving factor underlying the syndrome. If so, there may be some link between adipose tissue fat and ectopic fat. But the mechanisms underlying this connection are not clear. A stronger association appears to exist between excessive caloric intake and ectopic fat accumulation. Adipose tissue may act as a buffer to reduce the impact of excess energy consumption by fat storage; but once a constant weight has been achieved, it is unclear whether adipose tissue influences levels of ectopic fat. Another mechanism whereby adipose tissue could worsen the metabolic syndrome is through release of adipokines. This is an intriguing mechanism, but the impact of adipokines on metabolic syndrome risk factors is uncertain. Thus, many potential connections between adipose tissue and metabolic syndrome remain to unravelled.
129 citations
TL;DR: In this paper, the authors investigated the associations of novel imaging markers of adiposity, including visceral adipose tissue (VAT) and abdominal subcutaneous adiposes tissue (SAT), with the risk for cardiovascular disease (CVD) events in a multiethnic cohort of obese adults.
110 citations
TL;DR: This hypothesis that a substantial reduction in lifetime risk of incident coronary heart disease might be achieved if statin-based LDL-C lowering were initiated in young and middle-aged adults at an age before complex coronary plaques are common in the population is examined and the design of a currently recruiting trial is introduced.
49 citations
TL;DR: An inverse trend in all-cause mortality exists among men across LL, ML, and HL CRF groups and although all low-fit men should be targeted for physical activity intervention, it is especially important to target the LL CRF group.
Abstract: AB Purpose: A low level of cardiorespiratory fitness (CRF) is a strong and independent predictor of all-cause mortality in men; however, it is unknown whether a gradient of mortality risk exists within the lowest CRF category. Methods: A total of 6251 apparently healthy men (mean age, 48.7 +/- 6.3 yr) completed a comprehensive baseline clinical examination, including a maximal treadmill exercise test at Cooper Clinic between 1971 and 2006. In accord with previous studies using this cohort, low CRF was defined as a treadmill time in the first quintile within each age category of 40-49, 50-59, and 60-69 yr. The low CRF cohort was then grouped by tertiles (low/low, LL; mid/low, ML; and high/low, HL) using the same age categories. Results: After a mean follow-up period of 19.1 +/- 10.4 yr, 1259 deaths occurred. Adjusted all-cause mortality rates were 57.0, 31.1, and 34.4 deaths per 10,000 man-years across LL, ML, and HL CRF categories for the 40- to 49-yr-old age group (P trend = 0.007). Similar trends were seen across low CRF categories for the 50- to 59-yr-old and 60- to 69-yr-old age groups (P trend = 0.02 and 0.09, respectively). When using treadmill time as a continuous variable, each 1-min increment in treadmill time was associated with a 9%, 11%, and 15% reduction in risk of all-cause mortality among low-CRF men in the 40-49, 50-59, and 60-69 age groups, respectively. Conclusions: An inverse trend in all-cause mortality exists among men across LL, ML, and HL CRF groups. Although all low-fit men should be targeted for physical activity intervention, it is especially important to target the LL CRF group.
22 citations
TL;DR: The majority of efforts to halt atherosclerosis have been focused on limiting cholesterol influx into resident macrophages within the arterial wall by reducing circulating levels of atherogenic lipoproteins, which are collectively reflected by non–high-density lipoprotein cholesterol (non–HDL-C).
20 citations
01 Jan 2015
14 citations
TL;DR: The first author reviewed the 2013 American College of Cardiology/American Heart Association Guideline, which places priority on statin therapy on the basis of clinical outcomes.
2 citations
01 Jan 2015
TL;DR: Since the publication of ACC/AHA recommendations, considerable controversy has emerged on how best to develop cholesterol guidelines and potential approaches are suggested.
Abstract: Since the 1980s, cholesterol guidelines for Americans have been sponsored by The National Heart, Lung, and Blood Institute of the National Institutes of Health. These guidelines were produced by the National Cholesterol Education Program. From this program, an Adult Treatment Panel (ATP) has organized the major sets of guidelines. Three reports were issued by ATP. The third and last was updated by a smaller panel in 2004. More recently, the National Heart, Lung, and Blood Institute has turned the cholesterol guideline process over to the American College of Cardiology and the American Heart Association (ACC/AHA). Guidelines from other countries have generally followed the third ATP report. ACC/AHA guidelines have attempted to restrict their recommendations to information derived from randomized clinical trials. Thus, they are much narrower than ATP reports. The latter made recommendations on several lines of evidence, including clinical trials, epidemiology, genetics, and dietary and metabolic studies. Since the publication of ACC/AHA recommendations, considerable controversy has emerged on how best to develop cholesterol guidelines. This chapter examines this question and suggests potential approaches.
TL;DR: It is shown that the linear relationship between levels of low-density lipoprotein cholesterol and cardiovascular events extends to levels <50 mg/dl, and the findings are strongly consistent.