New Program at Associates In Cardiovascular Disease

New Program at Associates In Cardiovascular Disease (within the Atlantic Health System) Takes Aim at High Cholesterol Management

Recently, Associates In Cardiovascular Disease (AICD) launched a new program to help patients with dangerously high cholesterol levels get the focused care they need.

The Atlantic Lipid Lowering Treatment Optimization Program (ALLTOP) takes a comprehensive approach to managing patients with extremely elevated LDL (bad) cholesterol, particularly those with familial hypercholesterolemia — a genetic condition affecting approximately one in 250 people.

“Familial hypercholesterolemia is a common genetic abnormality, but it is underdiagnosed,” says Dr. Robert Fishberg, who co-leads ALLTOP. “We estimate there could be 19,000 patients who may have this condition in our care. The problem is it’s not often recognized, and it’s associated with early heart attacks and strokes.”

What makes this condition particularly dangerous is its silent nature.

“People are not symptomatic with it,” Dr. Fishberg says. “Sometimes the first instance of knowing you have a heart problem is when you have a heart attack or, unfortunately, sudden death.”

According to the Journal of Clinical Lipidology, ALLTOP’s goal is to demonstrate significant improvements in patient outcomes over its 36-month study period. With its targeted approach of more frequent monitoring and comprehensive support, Dr. Fishberg and his team expect to help 250 high-risk patients achieve and maintain healthier cholesterol levels.

“Early indicators suggest that patients could see their LDL levels drop from around 200 to below 100 mg/dL — a reduction that significantly decreases their risk of heart attacks and strokes,” Dr. Fishberg says. “This proactive approach to cardiovascular health represents a significant shift from reactive treatment to preventive care.”

How ALLTOP works

ALLTOP takes a unique approach by using nurse practitioners to provide more frequent, focused care. While traditional doctor’s offices typically see patients once or twice a year, ALLTOP patients receive check-ups every three months. This increased monitoring helps patients stay on track with their treatment plans and reach their cholesterol goals.

Dr. Fishberg and his team are enrolling patients identified through Atlantic Health System’s electronic medical record (EMR), with primary care providers playing a crucial role in connecting high-risk patients with this specialized care.

“Most doctors do a good job taking care of patients, but having a nurse practitioner that’s focused on helping patients achieve optimal cholesterol levels by checking on them every three months can make a significant difference,” Dr. Fishberg says.

ALLTOP’s strength lies in its holistic approach to cholesterol management. Rather than simply prescribing medication, ALLTOP creates a comprehensive support network for each patient, including:

  • Regular consultations with nutritionists
  • Access to clinical pharmacists
  • Support from social workers
  • Genetic testing when appropriate
  • Family member screening for those at risk
  • Community health resources

This multi-faceted approach helps address various barriers to care, whether it’s related to medication costs, lifestyle factors or educational needs.

“We’re trying to look at the barriers of care that prevent patients from managing their cholesterol levels,” Dr. Fishberg says. “And there’s many of them — misinformation, cost of drugs and lifestyle choices. ALLTOP can help address a lot of these issues.”

5 ways to maintain (or lower) your cholesterol

February is American Heart Month, so now is the perfect time to pay attention to your cholesterol levels, Dr. Fishberg says.

Current treatment guidelines recommend that patients at high risk should maintain their LDL cholesterol below 100, while those who have had a heart attack or are at very high risk should aim for levels below 70 or even 55. ALLTOP’s preliminary results with its first 68 patients show promise in helping those with significantly elevated levels — averaging around 200 — work toward these goals.

Dr. Fishberg says that successful cholesterol management isn’t just about medication. He encourages patients to:

  • Eat a Mediterranean diet
  • Exercise for 30 minutes a day
  • Reduce stress levels
  • Get eight hours of sleep each night
  • Know your numbers: blood pressure, blood sugar and lipid numbers

“ALLTOP represents AICD and Atlantic Health System’s commitment to preventing heart disease through early intervention and comprehensive care,” says ALLTOP’s Nurse Practitioner Deatrah Dubose. “By combining focused medical management with lifestyle support and family screening, the program helps high-risk patients avoid serious cardiac events and maintain better heart health for the long term.”

If you’re a physician or patient whose interested in learning more, call (973)467-0005.

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