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Lipid Talk: Identifying and Engaging High-Risk Patients

Clinical pharmacology and therapeutics

General Practice

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Description

This program is supported by an independent education grant from MSD. It is intended for healthcare professionals globally.

In this 15-minute podcast, leading cardiovascular expert Christopher P. Cannon, MD, joins us to discuss practical strategies for recognising and managing high-risk patients who may be silently progressing towards atherosclerotic cardiovascular disease (ASCVD). Building on the concept of cumulative LDL-C exposure introduced in the first episode, Dr Cannon explores how to identify familial hypercholesterolaemia (FH), integrate risk-enhancing factors beyond standard calculators, and address the real-world barriers that lead to clinical inertia. The session also features patient advocate, who offers her first-hand experience with FH, highlighting the human side of delayed diagnosis and treatment access.

Accreditation: 0.25 AMA PRA Category 1 Credits™

Session Highlights

Recognise the clinical “red flags” for familial hypercholesterolaemia and when to initiate early, aggressive lipid-lowering therapy.
Understand key risk-enhancing factors (e.g. chronic kidney disease, metabolic syndrome, inflammation, elevated Lp(a)) that are not captured by traditional pooled cohort equations.
Examine how social determinants of health—such as income, environment, and access to care—contribute to ASCVD risk.
Identify and overcome clinical inertia in lipid management through awareness of updated guidelines and non-statin therapy options.
Review practical approaches to therapy access and affordability, including navigating prior authorisations and multidisciplinary care support.
Hear directly from a patient on the challenges of delayed recognition and the importance of clinician engagement and empathy.

Who Should Watch

Cardiologists
Endocrinologists/Lipidologists
Primary Care Physicians
Nurse Practitioners & Physician Assistants
Pharmacists
Diabetologists
Other healthcare professionals managing lipid disorders and ASCVD risk worldwide

Presented by

Christopher P. Cannon, MD – is a Professor of Medicine at Harvard Medical School, and senior physician in the Cardiovascular Division at Brigham and Women’s Hospital. He worked for 25 years as an investigator in the TIMI Study Group, and is now a member of the Brigham’s Cardiovascular Innovation group, serving as Director of Education. Dr. Cannon has published over 1000 original articles, reviews or book chapters in the field of acute coronary syndromes and prevention and has authored or edited 20 books. He has received numerous awards, including leadership awards from the American College of Cardiology, American Heart Association and National Lipid Association.

The episode includes a patient perspective from Julie Stevens, an advocate with the National Lipid Association, who shares her journey with familial hypercholesterolaemia and offers an authentic look at the barriers and breakthroughs in lipid care.

Continuing Education Information

This activity received monetary support through an independent education grant from MSD.

This continuing education activity will be provided by AffinityCE and MedAll. Physicians will be eligible for AMA PRA Category 1 Credit™. A statement of participation is available for other healthcare professionals.

Disclosures

Dr Christopher P. Cannon has disclosed financial relationships within the past 24 months with the following ineligible companies: Amgen, Better Therapeutics, Boehringer Ingelheim (BI), and Novo Nordisk (research grants); salary support from the Colorado Prevention Centre (CPC) Clinical Research, which receives funding from Amgen, Bayer, Cleerly, Esperion, Lexicon, and Silence; and advisory board memberships with Amryt/Chiesi, Amgen, Ascendia, Biogen, Boehringer Ingelheim, Bristol Myers Squibb (BMS), CSL Behring, Genomadix, Lilly, Janssen, Lexicon, Milestone, Novartis, Pfizer, and Rhoshan.

These disclosures are made in accordance with ACCME standards to ensure transparency and objectivity in continuing education. Dr Cannon intends to discuss non-FDA uses of drug products and/or devices and their unlabelled indications, and will disclose this to the audience when such discussion takes place.

Julie Stevens has no financial relationships with the ineligible companies to disclose.

AffinityCE staff, MedAll staff, and all planners and reviewers have no relevant financial relationships with ineligible companies to disclose.

Mitigation of Relevant Financial Relationships

AffinityCE adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CME activity, including faculty, planners, reviewers, or others, are required to disclose all relevant financial relationships with ineligible companies. Relevant financial relationships were mitigated by the peer review of content by non-conflicted reviewers prior to the commencement of the program.

Activity Accreditation for Health Professions

Physicians

This activity will be planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AffinityCE and Medall. AffinityCE is accredited by the ACCME to provide continuing medical education for physicians.

AffinityCE designates this enduring activity a maximum of 0.25 AMA PRA Category 1 Credits™.

Physician Assistants

This activity will be planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AffinityCE and MedAll AffinityCE is accredited by the ACCME to provide continuing medical education for physicians.

AffinityCE designates this enduring activity a maximum of 0.25 AMA PRA Category 1 Credits™. Physician assistants should claim only the credit commensurate with the extent of their participation in the activity.

Nurse Practitioners

This activity will be planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AffinityCE and MedAll. AffinityCE is accredited by the ACCME to provide continuing medical education for physicians.

AffinityCE designates this enduring activity a maximum of 0.25 AMA PRA Category 1 Credits™. Nurse practitioners should claim only the credit commensurate with the extent of their participation in the activity.

Nurses & Other Professionals

All other health care professionals completing this continuing education activity will be issued a statement of participation indicating the number of hours of continuing education credit. This may be used for professional education CE credit. Please consult your accrediting organization or licensing board for their acceptance of this CE activity.

Criteria for Claiming CPE Credit: Participants must have listened to the entire podcast. Attendance is monitored online for participation in the entire activity.

System Requirements

Mobile device (e.g., large-format smart phone; laptop or tablet computer) or desktop computer with a video display of at least 1024 × 768 pixels at 24-bit color depth, capable of connecting to the Internet at broadband or faster speeds, with a current version Internet browser and popular document viewing software (e.g., Microsoft Office, PDF viewer, image viewer) installed. Support for streaming or downloadable audio-visual materials (e.g., streaming MP4, MP3 audio) in hardware and software may be required to view, review, or participate in portions of the program

Participation Costs

There is no cost to participate in this program.

This activity is available from October 30th 2025 until March 20th 2026, estimated time to complete: 15 minutes.

Learning objectives

Identify and stratify patients at elevated risk for ASCVD, including those with familial hypercholesterolaemia (FH), underserved populations, and high unmet needs. (Moore’s level 4)
Apply current cholesterol management guidelines, including LDL-C targets, adherence strategies, and treatment escalation approaches. (Moore’s level 5)
Design strategies to overcome clinical inertia and streamline access to guideline-recommended lipid-lowering therapies for different patient profiles. (Moore’s level 4)

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Computer generated transcript

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Welcome to the Quick Consult podcast, brought to you by Metall. Before starting this podcast, please review the faculty information, disclosure statements, and learning objectives using the link in the episode description. To claim your CME credit, complete the evaluation using the link in the episode description. This podcast is a continuing education activity managed and accredited by Affinity CE in collaboration with META. This activity is supported by an independent medical education grant from MSD. Welcome back to Lipid Talk. In our last episode we discussed the powerful impact of a patient's lifetime LDLC exposure. Today we're moving from why to who, identifying and engaging the high risk patients, with a deep dive into risk stratification, especially for those with familial hypercholesterolemia. Or FH and underserved populations. Our goal is to address the gap where many clinicians report difficulty accurately identifying and stratifying high-risk patients. I'm once again honored to be joined by Doctor Christopher Cannon. Doctor Cannon, thanks so much for being here again. Certainly, it's delight to join. Let's start with familial hypercholesterolemia or FH. The data shows that those with FH have a persistently elevated LDLC increasing their risk of coronary artery disease significantly. For a primary care physician or specialist, what are the red flags and how should we approach screening and diagnosis for FH? Uh, this is an excellent question, and the ACCHA guidelines have pulled out an LDL of above 190 as the extremely high risk and, and often familial hypercholesterolemia. Um, another component of that is if the LDL is maybe 180 or 190 at, at young age, and so if you're seeing someone and looking back and when they're in their twenties or thirties, if it was already at that very high level, uh, that would suggest FH. Then obviously asking for parents, um, uh, you know, if they also, but many people will have high cholesterol as a patient, you know, would recount it, and not necessarily be the, you know, the very high. Um, and so, uh, I really rely a lot on the Early LDL levels being very high and persistently high as a marker and red flag. Um, and so, you know, the red flag there is that many of these people were told, you know, eat healthy, exercise more, which, of course, doesn't change the genetics. It's always good to eat healthy and exercise more, but that won't change. And so if you do see this very early and very high levels, that's when, you know, considering early treatment for the FH should be considered. Traditional 10 year ASCVD risk calculators like the pooled cohort equations can sometimes underestimate lifetime risk, particularly for younger adults or specific groups. What are the most important risk enhancing factors that clinicians should integrate into the risk assessment to ensure they don't miss patients who are silently progressing towards ASCVD? This is a really nice concept that reminds us all that atherosclerosis is a multifactorial disease. And while LDL is the most modifiable, uh, and most proven, uh, we do want to calculate all these other factors, uh, that the term risk enhancing factors is a very good one. And so, um, the ACCHA guidelines has a list of these, uh, that all make perfect sense. Interestingly, the, the second one they list is a persistently elevated LDL above 160, which we talked about in the earlier segment of, you know, the, the long exposure to high LDL. Um, which, you know, makes total sense. A family history of premature atherosclerosis, uh, you know, am I in their 50s or something would be another sign that maybe there's something in the, in the genetics of that family that predisposes. Um, uh, overall, metabolic syndrome is listed, and I think obesity and glucose intolerance are sort of wrapped together in that, uh, concept that, you know, if we're there with a patient who's overweight and not exercising much, and, you know, has markers of the metabolic syndrome, and, uh, specifically, this does call out a high CRP which is part of that. Um, or elevated triglycerides is another part of, of that, that those are patients who have multiple other components of, uh, risk, uh, factors that are contributing to the actual atherosclerosis. So if there's inflammation, and this would be true in patients with inflammatory diseases like rheumatoid arthritis, etc. Um, that that's another axis that would increase the chance of developing, uh, atherosclerosis at whatever LDL level. And so the more of these other risk enhancing factors, the more worried we should get, because it's not just the LDL. Um, I've also used this in the converse actually, of people who have everything perfect, you know, they're exercising, their right body weight, the low CRP, they have no other major diseases, and their LDL is a little high, uh, you know. Not perfect, but a little higher than we'd like, one could maybe tolerate that, you know, um, that you really have to factor in these other factors in deciding how intensive to be in managing those factors and also the LDL. So it's a wonderful concept that I think is important to uh bring into the discussion of treating LDL is to make sure you have the full context of patients. Um, I'll I'll add just one other thing that we're focusing more on is lipoprotein A is another lipid marker. Different, you know, lipid, uh, but it can also get into arteries and, and multiple studies have shown the higher LPLA levels, the higher the risk of atherosclerosis, and, and so that's yet another group of patients that are being identified more and more as we do more screening for that, that then we have to worry about the LDL for now and, and maybe in the future we'll have treatments for, for the LPLA itself. Another critical gap is the suboptimal risk stratification in underserved populations. We know that social determinants of health can significantly influence ASCV risk. What role do factors like low income, neighborhood environment, and food insecurity play in our patients' risk, and how can clinicians practically factor these in when deciding on the need for lipid lowering therapy? So this is another important discussion of, of the practicalities that, you know, if we waltz in and say, oh, you've got to take this and that and, and, you know, uh, come back when you're doing better, uh, that won't actually help the patients. And so, you know, asking what types of foods they have, what, you know, do they have access to. Um, you know, could they access fresher foods and, you know, healthier things, um, you know, as one option. Um, you know, income is a factor for drug costs that we obviously have to factor in for everyone, but, you know, working with patients to make sure that they'll be able to get their medications. There are often, you know, drug assistance programs and, and certainly using generics whenever we can. Um, you know, so working with patients and I often pull out, you know, GoodRx is one of these websites, or Mark Cuban has a website that has, you know, the lowest cost for many medications. Um, and so working with them and showing that you care to help them actually implement this can, you know, hopefully mitigate some of these, uh, social determinants of health. To gain a perspective from the patient side, we have Julie Stevens, a patient advocate from the National Lipid Association. Julie, can you share a bit about your personal journey and what the process was like for you to get an accurate diagnosis? So