The Melbourne Lipid Centre
Consultants
Professor David L Hare OAM MBBS DPM FRACP FCSANZCP
Professor Edward Janus MD PhD FRACP FRCPA FCSANZ
Dr Odgerel Tumur MBBS PhD FRACP Cert.Lipid (EAS)
Dr Shirin Sarejloo MD FRACP Cert.Lipid (EAS)
Lipid Disorders and Heart Health
Prevalence: Apart from the Spanish Flu pandemic 100 years ago, cardiovascular disease (CVD) has remained every year the most common cause of death in Australia for both women and men.
CVD is largely driven by genetic disorders, running with higher prevalence in certain families and people groups, and exacerbated by sociological and life-style factors.
Prevention: Almost all clinical coronary artery disease is potentially preventable.
Most common lipid abnormalities producing CVD are:
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High LDL-cholesterol
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High Lipoprotein (a)
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Combined dyslipidaemias
Family History: Every day we elicit “Family History” as the clinical equivalent of “Genomic Testing”. Unfortunately, this has become much more difficult over recent years. Statins have been available in Australia for the last 30 years. Thus there is a whole generation of Australians in whom a genetic predisposition can have been potentially masked by treatment of the phenotype in their parents and other relatives, thus resulting in a false sense of security.
Familial Hypercholesterolaemia: Whilst we know of many different genes that contribute to CVD, there are some very serious genetic conditions that together we call “Familial Hypercholesterolaemia” or just “FH”.
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The FH gene variants are autosomal dominant and therefore affect half of all 1st order relatives.
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In Australia, it affects about 100,000 people but less than 1 in 10 people born with FH know that they have it.
Lipoprotein (a): This gene variant is also autosomal dominant and extraordinarily common. In a recent series at the Austin Hospital, 50% of all ACS patients under 70 years of age had elevated levels of Lp(a), rather than just other dyslipidaemias.
Services provided by The Melbourne Lipid Centre
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Assessment and management of all lipid disorders
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Collaboration with general practitioners and other specialists
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Existing coronary disease detected and managed
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Tight lipid-lowering targets to stop progression and even reverse coronary artery disease
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Full range of interventions are available, including:
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Inhibiting cholesterol absorption
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Preventing manufacture of cholesterol
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Removing cholesterol from the circulation
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Genetic testing and counselling
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Cascade detection for relatives
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PCSK9 inhibitors
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Fibrates for limiting progression of diabetic retinopathy
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Services for patients, their children and relatives
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Assessing exercise safety for personal and competitive activities
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Patients preferably referred by their general practitioner but service also available to cardiologists and other specialists