For Professionals

Sessions Available

We have modern, high quality, serviced consulting rooms available on a sessional basis for medical professionals. There is a pathology service available next door and many GP practices close by.

Box Hill Hospital and Epworth Eastern Private Hospital are close by.
If you would like more information please ring Jillian, our practice manager 0418 552 531

The Melbourne Lipid Centre

Prevalence: Apart from the Spanish Flu pandemic 100 years ago, cardiovascular disease 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:

  • High LDL-cholesterol
  • High Lipoprotein (a)
  • 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”.

  • The FH gene variants are autosomal dominant and therefore affect half of all 1st order relatives.
  • 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

  • Assessment and management of all lipid disorders
  • Collaboration with general practitioners and other specialists
  • Existing coronary disease detected and managed
  • Tight lipid-lowering targets to stop progression and even reverse coronary artery disease
  • Full range of interventions are available, including:
    • Inhibiting cholesterol absorption
    • Preventing manufacture of cholesterol
    • Removing cholesterol from the circulation
    • Genetic testing and counselling
    • Cascade detection for relatives
    • PCSK9 inhibitors
    • Fibrates for limiting progression of diabetic retinopathy
  • Services for patients, their children and relatives
  • Assessing exercise safety for personal and competitive activities
  • Patients preferably referred by their general practitioner but service also available to cardiologists and other specialists

 

References  

Recent NIH (USA) pubmed listed publications on cardio-metabolic disease and lipids co-authored by Professor David Hare

  1. Quality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with coronary heart disease (QUEL): protocol for a 24-month cluster randomised controlled trial in primary care. BMC Fam Pract. 2020 Feb 14;21(1):36. doi: 10.1186/s12875-020-01105-0.
  2. The Prevalence of Elevated Lipoprotein(a) in Patients Presenting with Coronary Artery Disease. Heart, Lung and Circulation 2020 – in press March 2020
  3. Familial Hypercholesterolaemia in 2020: A Leading Tier 1 Genomic Application. Heart Lung Circ. 2019 Dec 24. pii: S1443-9506(19)31552-5. doi: 10.1016/j.hlc.2019.12.002. [Epub ahead of print] Review.
  4. Prevalence of pre-existing dysglycaemia among inpatients with acute coronary syndrome and associations with outcomes. Diabetes Res Clin Pract. 2019 Aug;154:130-137. doi: 10.1016/j.diabres.2019.07.002. Epub 2019 Jul 4.
  5. Status of PCSK9 Monoclonal Antibodies in Australia. Heart Lung Circ. 2019 Oct;28(10):1571-1579. doi: 10.1016/j.hlc.2019.04.014. Epub 2019 May 8. Review.
  6. Fat from dairy foods and ‘meat’ consumed within recommended levels is associated with favourable serum cholesterol levels in institutionalised older adults. J Nutr Sci. 2019 Mar 21;8:e10. doi: 10.1017/jns.2019.5. eCollection 2019.
  7. Higher long-term adherence to statins in rural patients at high atherosclerotic risk. J Clin Lipidol. 2019 Jan – Feb;13(1):163-169. doi: 10.1016/j.jacl.2018.11.004. Epub 2018 Nov 15 (including Professor Janus)
  8. Work stress and mortality in people with cardiometabolic disease. Lancet Diabetes Endocrinol. 2018 Oct;6(10):766-767. doi: 10.1016/S2213-8587(18)30232-8.
  9. Glucocorticoid-Induced Insulin Resistance in Men Is Associated With Suppressed Undercarboxylated Osteocalcin. J Bone Miner Res. 2019 Jan;34(1):49-58. doi: 10.1002/jbmr.3574. Epub 2018 Sep 17.
  10. Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery. N Engl J Med. 2018 May 31;378(22):2069-2077. doi: 10.1056/NEJMoa1716026. Epub 2018 Apr 30.
  11. Acute exercise alters skeletal muscle mitochondrial respiration and H2O2 emission in response to hyperinsulinemic-euglycemic clamp in middle-aged obese men. PLoS One. 2017 Nov 21;12(11):e0188421. doi: 10.1371/journal.pone.0188421. eCollection 2017.
  12. Intensive LDL Reduction Post Acute Coronary Syndromes: A Catalyst for Improved Outcomes. Heart Lung Circ. 2016 Nov;25(11):1051-1054. doi: 10.1016/j.hlc.2016.09.005. No abstract available.
  13. Acute High-Intensity Interval Exercise-Induced Redox Signaling Is Associated with Enhanced Insulin Sensitivity in Obese Middle-Aged Men. Front Physiol. 2016 Sep 16;7:411. eCollection 2016.
  14. Evidence for CD34/SMA positive cells in the left main coronary artery in atherogenesis. Acta Histochem. 2016 May;118(4):413-7. doi: 10.1016/j.acthis.2016.04.005. Epub 2016 Apr 14.
  15. Childhood Psychosocial Factors and Coronary Artery Calcification in Adulthood: The Cardiovascular Risk in Young Finns Study. JAMA Pediatr. 2016 May 1;170(5):466-72. doi:
  16. Muscle atrophy in patients with Type 2 Diabetes Mellitus: roles of inflammatory pathways, physical activity and exercise. Exerc Immunol Rev. 2016;22:94-109. Review.
  17. Can patients presenting with acute coronary syndrome be screened for diabetes using glycosylated haemoglobin? Med J Aust. 2015 Nov 16;203(10):401-1.e1. No abstract available.
  18. The effect of hyperinsulinaemic-euglycaemic clamp and exercise on bone remodeling markers in obese men.Bonekey Rep. 2015 Aug 26;4:731. doi: 10.1038/bonekey.2015.100. eCo llection 2015.
  19. Simvastatin impairs the induction of pulmonary fibrosis caused by a western style diet: a preliminary study. J Cell Mol Med. 2015 Nov;19(11):2647-54. doi: 10.1111/jcmm.12637. Epub 2015 Aug 25.

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