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Expert consensus focuses on individual planning to bring down elevated LDL. Recently I met with Nancy, a 72-year-old woman with coronary artery disease, to review her latest cholesterol results. Despite taking a statin, following a healthy diet, and exercising regularly, her low-density lipoprotein (LDL) cholesterol remained above our target. "What else can I do?" she asked. "When I increase my statin dose I get terrible leg pains. But I don’t want to have another heart attack!" When elevated, LDL contributes to cardiovascular disease, which can cause a heart attack or stroke. Taking statin drugs can drop LDL levels in most people by about 30%, substantially lowering this risk. Usually, these commonly prescribed drugs work effectively with tolerable side effects. But what if a person’s LDL level remains too high on their maximally tolerated dose? An expert consensus report issued by the American College of Cardiology lays out a clear path for next steps. What is a healthy target for LDL cholesterol? Target LDL depends on many factors, including your age, family history, and personal history of cardiovascular disease. For people at intermediate risk, LDL should be lowered by 30% to 50%. For those who have already had a heart attack, target LDL is no more than 70 mg/dl (note: automatic download). Which non-statin therapies are recommended first? Five non-statin therapies described in this post aim to help people achieve target LDL goals while minimizing side effects. They may be combined with a statin or given instead of statins. Each helps lower LDL cholesterol when diet and statins are not sufficient, such as when there is a family history of high cholesterol (familial hypercholesterolemia). But so far, only two options are proven to reduce cardiovascular risk — the risk for heart attack, stroke, heart failure, and other issues affecting the heart and blood vessels. Follow me on Twitter @daraleelewismd . The post Trying to lower stubbornly high LDL cholestrol? appeared first on Harvard Health Blog . 

Part II: POTS: Diagnosing and treating this dizzying syndrome - Harvard Health

In this article Dr. Lee Lewis will explain what’s known so far about the triggers and hallmark symptoms of POTS. In a later post, She will discuss diagnosis and treatment.

In this article from Harvard Medicine, Dr. Dara Lee Lewis discusses the crucial role that women physicians play in advocating the growing field of Women's Health.

My patients commonly ask me whether they should try one supplement or another. Often my answer is equivocal because for most supplements we just don’t have enough evidence to give a definite answer.

Compared to the general population, people with cardiovascular disease (CVD) were more than twice as likely to contract severe forms of COVID-19.

Intensive blood pressure lowering was not associated with orthostatic hypotension, and in fact intensive treatment decreased the risk of orthostatic hypotension.

Researchers found that there was a significant rise in stress cardiomyopathy during the COVID-19 period, with stress cardiomyopathy occurring more than four times as often as usual during March and April 2020.