Cardiology Lipid Management Service

Who Are We?

Dr. Vincent Maher


The Lipid Management Service is provided by Professor Vincent Maher, Consultant Cardiologist and Lipidologist and Lipid Nurse Manager Ruth Agar. 

Our telephone number is 01-414 2052 

The Cardiology Risk Factor Clinic is run by Professor Maher and Ms Agar each Friday morning in the Adult Out Patient Department

What Are Lipids?

Lipids are another name for cholesterol. Cholesterol is a waxy, fat-like substance that’s found in all cells of the body.Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. However, cholesterol also is found in some of the foods you eat.

Cholesterol travels through your bloodstream in small packages called lipoproteins (lip-o-PRO-teens). These packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of both types of lipoproteins is important.

LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood from your heart to your body.)

HDL cholesterol sometimes is called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body.

What is High Blood Cholesterol?
High blood cholesterol is a condition in which you have too much cholesterol in your blood. By itself, the condition usually has no signs or symptoms. Thus, many people don’t know that their cholesterol levels are too high.

People who have high blood cholesterol have a greater chance of getting coronary heart disease, also called coronary artery disease. (In this article, the term “heart disease” refers to coronary heart disease.)

The higher the level of LDL cholesterol in your blood, the GREATER your chance is of getting heart disease. The higher the level of HDL cholesterol in your blood, the LOWER your chance is of getting heart disease.

Coronary heart disease is a condition in which plaque (plak) builds up inside the coronary (heart) arteries. Plaque is made up of cholesterol, fat, calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis).Over time, plaque hardens and narrows your coronary arteries. This limits the flow of oxygen-rich blood to the heart.

Eventually, an area of plaque can rupture (break open). This causes a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.

If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, angina (an-JI-nuh or AN-juh-nuh) or a heart attack may occur.

Angina is chest pain or discomfort. It may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.

A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. If blood flow isn’t restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious problems or death.

Plaque also can build up in other arteries in your body, such as the arteries that bring oxygen-rich blood to your brain and limbs. This can lead to problems such as carotid artery disease, stroke, and peripheral artery disease.

Information and graphics courtesy of the NIHLBI https://www.nhlbi.nih.gov/health/health-topics/topics/hbc 

What are Lipids - Cardiology

What Do We Do?

The Lipid Management Service aims to provide a specialist service for people with high cholesterol or cholesterol disorders that are genetic in nature (occurs in families), or in whom treatment is challenging.

We will update this site regularly with information that we hope you will find useful.

Why is it so important?

  • High cholesterol levels increase one’s life time risk of heart disease and stroke.
  • There are no official studies that encompass the whole Irish population regarding the occurrence of cholesterol related disorders. Based on figures from an English population, which is not dissimilar to ours, it is estimated that one in 12 Irish people have markedly high cholesterol levels.
  • In addition, it is estimated that one in nine people have insufficient HDL cholesterol levels, which normally protect against heart disease.
  • Genetic disorders of “bad” cholesterol (LDL) occur in approximately one in 200 people. This means that roughly 24,000 Irish people with these disorders are at very high risk of developing premature heart disease if untreated.
  • Approximately 80% of individuals are unaware of their cholesterol problems and many are only diagnosed after a heart attack or stroke.
  • In those with high cholesterol, or insufficient HDL cholesterol, who also have diabetes, obesity, high blood pressure or are smokers, the risk of heart disease is very high.
  • Even for individuals with known high cholesterol, challenges may exist due to poor treatment response rates, drug intolerances and co-existing disorders which hamper treatment.
  • Ireland lacks accurate information on the extent of its cholesterol related problems. There is no national screening strategy or dedicated resources in hospitals, primary care or the community to diagnose and treat cholesterol-related disorders effectively so as to reduce cardiovascular risk.

What should be done?

Firstly, we need to define the extent of cholesterol related problems in Ireland.

A carefully planned national research study needs to be performed to establish the extent of cholesterol-related disorders in Ireland, as has been done in England.

We also need to establish the level of current cholesterol services in Ireland. A national service audit is currently underway. 

It is important to establish dedicated centres which are adequately resourced to work with patients with challenging cholesterol disorders, facilitate family screening and help refine patients’ diagnoses with the use of more specialised investigations. These centres will help provide educational initiatives and support for other satellite locations that provide cholesterol management services. 

To establish such dedicated centres, a prototype model centre needs to be initially developed. This will help identify the scale of the problem, the diagnostic difficulties, resource requirements and service provision needs that other hospitals may use as a template.

Why Tallaght Hospital?

There has been a tradition of Preventative Cardiology services based at Tallaght Hospital since its foundation. As a consequence, a number of the components required to initiate a dedicated advanced cholesterol management service are already in place. Close collaboration between the cardiology department, clinical biochemistry department, endocrinology department and vascular services has facilitated an ethos of preventative orientated strategies.

Many clinical trials and challenging problems in cholesterol related disorders have been managed effectively at Tallaght Hospital. It is therefore our hope to utilise all of these resources together with additional staff and diagnostics to develop an Advanced Lipid Management and Research (ALMAR) Centre at Tallaght Hospital.

ALMAR Centre

We aim to establish the Advanced Lipid Management and Research (ALMAR) Centre at Tallaght Hospital, as the initial centre in Ireland for the study and treatment of complex cholesterol disorders.

Professor Maher and colleagues are undertaking to cycle the length and breadth of Ireland this July to help raise funds for this worthy cause. In addition to cycling, the team will stop at various points around the country for a “Cholesterol Happens” event, where they will invite members of the public to have their cholesterol tested – to “Know Your Number”.

For information on the cycle route and the stops for the “Cholesterol Happens – Know Your Number” events please click here

ALMAR Centre Fundraising Event

CHOLESTEROL HAPPENS - KNOW YOUR NUMBERS"

Professor Vincent Maher, Consultant Cardiologist at Tallaght Hospital and Irish representative on the Global Familial Hypercholesterolemia Network group, is cycling the length and breadth of Ireland to raise awareness about cholesterol and to raise funds for the development an Advanced Lipid Management and Research (ALMAR) Centre at Tallaght Hospital

There are two purposes to the “Cholesterol Happens – Know Your Number” event

  1. Raise awareness about Cholesterol and why people need to know their cholesterol ‘numbers’
  2. Raise funds to develop an initial ALMAR centre at Tallaght hospital.

Professor Maher and colleagues plan to cycle the length and breadth of Ireland this summer. We hope that this inaugural event will evolve into an annual awareness campaign for cholesterol, its risk factors and treatment.

  • The first cycle will begin on June 30th 2017 in Malin Head, Co. Donegal and finish on July 4th 2017 in Mizen Head, Co. Cork.
  • The second cycle will begin on July 7th 2017 in Dooagh Achill Island, Co. Mayo and will finish in Dillon Park, Dalkey, Co. Dublin on July 9th

Cycle map, Carioloogy, Lipid Management, Charity Cycle

In addition to fundraising, the equally important focus of this event is to offer free cholesterol testing and cholesterol education to the public at different stops along the way.

If you would like to support this worthy cause please click on this LINK

Research

Professor Maher was this year awarded a research grant from the Meath Quality Improvement Fund at Tallaght Hospital with the aim of developing services and care pathways for patients with complex lipid disorders such as those with severe hypercholesterolaemia, triglyceride disorders and those with inadequate levels of HDL cholesterol.  All of these disorders are associated with significant patient risks.

Resources & Information

We aim to update this area with useful resources and links, so please check back regularly.

Cholesterol Basics 

Familial Hypercholesterolaemia