The Cholesterol Management Center at the New England Heart Institute is the first clinic of its kind in New Hampshire dedicated to helping people of all ages reduce their cholesterol and risk of heart disease. At the Cholesterol Management Center, we treat all risk factors for heart disease, including diabetes, hypertension, the metabolic syndrome, obesity and smoking. We use both standard and advanced lipid blood testing, and we are skilled in assessing well-known and emerging risk factors for coronary artery disease. We treat abnormal cholesterol levels with all currently available medications, and we also participate in clinical trials for new drugs that may offer our patients an early opportunity for cutting-edge care. We have expertise in dietary and exercise counseling, and, in cases where diet, lifestyle, and medication are not enough, we also offer apheresis to remove the bad cholesterol from the patient’s blood.
Our Cholesterol Management Center TeamThe Cholesterol Management Center is under the direction of Peter Klementowicz, MD, FACC. Dr. Klementowicz is the only board-certified lipidologist cardiologist in New Hampshire. The team includes Kristine Ziemba, ARNP; Lynn Scott, ARNP; Phlebotomist, Sharon Vega, MA; Patient Service Representative, Susan Malboeuf; Office Coordinator, Amanda Dahl and Director of Cardiovascular Wellness, Janet Troski, MSN, RN. Together, they provide the most up-to-date expertise in the area of cholesterol management in the state.
Heart Disease and CholesterolHeart disease is a leading cause of death in men and women. Cholesterol plays an important role in cardiac disease, and its treatment reduces that risk. Cholesterol is a fatty, wax-like substance found in our bloodstreams. It is beneficial to the body in that it helps make the cells in our body and is used to produce hormones which control many body systems. Cholesterol can enter the bloodstream in two ways. One is through dietary ingestion. This is primarily in the form of saturated fat. The second way is through production of cholesterol by the liver. This may be influenced by inherited factors. The liver can also remove cholesterol from the blood, but this is inhibited by a high fat diet. If there is too much cholesterol in the blood, it works its way into the artery wall causing blockages in coronary arteries. When the coronary arteries build up with cholesterol, the plaque can rupture leading to a heart attack or angina.
| Current Guidelines for Normal Cholesterol Values |
For Adults:
|
Desirable level
|
Total Cholesterol
|
<200mg/dl
|
Triglycerides
|
<150mg/dl
|
LDL (bad cholesterol)
|
<100mg/dl is optimal
<70mg/dl for people with heart disease
|
HDL (good cholesterol)
|
>45mg/dl for men
>50mg/dl for women
|
For Children:
|
Desirable Level
|
Total Cholesterol
|
<170mg/dl
|
Triglycerides
|
<100mg/dl
|
LDL
|
<110mg/dl
|
HDL
|
>40 mg/dl for boys
>50 mg/dl for girls |
All Americans over the age of 20 should know their full cholesterol profile. Children with a family history of heart disease, or whose parents have high cholesterol or other heart disease risk factors such as diabetes, should likewise be screened at an earlier age.
A person’s total cholesterol is a composite of VLDL, LDL, and HDL particles. Each of these blood fats is important and needs to be evaluated carefully. Triglycerides can be described as stored energy and are mainly composed of carbohydrates and some fat. They contribute to the heart disease process. LDL cholesterol is the ‘bad’ cholesterol and is one of the main components of plaque. HDL, or ‘good’ cholesterol, is involved in cleaning up the LDL from the blood.
What Happens in a Typical Visit to the Cholesterol Management Center?
An initial visit to the Cholesterol Management Center includes a complete medical history and physical exam, a complete cholesterol profile, an exercise assessment and a dietary evaluation. In some cases, additional blood levels will be measured and evaluated. These additional laboratory studies allow the Cholesterol Management Center team to determine more precisely a person’s overall cardiac risk status.
At times, an individualized diet and exercise plan will be sufficient to fully normalize a person’s cholesterol values. Our team works to provide a lifestyle plan that is tailored to each individual rather than a “one size fits all” plan. In addition to a diet that helps lower cholesterol, we promote weight loss when indicated. Exercise is key to weight loss and can benefit cholesterol levels. In other situations, medications will be needed to normalize cholesterol values. We work with each individual to tailor pharmaceutical treatment to their individual needs, tolerances, and cholesterol goals.
In extreme cases where diet, medication, and lifestyle are not enough to reach a person’s cholesterol goals, we are fortunate to be able to offer LDL apheresis. In this process, LDL cholesterol is removed from the blood in a process similar to dialysis. It is typically done once every two weeks. The New England Heart Institute Cholesterol Management Center is one of only 60 sites in the United States to offer this technique.
What Happens in a Follow-up Visit to the Cholesterol Management Center?
During your follow up visits, any new medical history is obtained and a brief physical is performed. Your lab work can be obtained on site and immediate results can be provided to you. The Cholesterol Management Center team will discuss your new lipid profile, any other lab work, and recommend that you either continue with the original treatment plan or proceed with a new treatment plan. You will have a follow-up discussion with the dietitian and a review of your exercise program.
Location and Hours of Operations
The Cholesterol Management Center is located in the New England Heart Institute of Catholic Medical Center, 100 McGregor Street, Manchester. In addition to clinic hours at the New England Heart Institute site, patients are seen in Nashua and Peterborough on the first and third Monday of each month (see location information below). The Cholesterol Management Center can be accessed Monday-Friday by calling 603.663.6549. Or for more information about the Cholesterol Management Center, call ASK-A-NURSE® at 603.626.2626.
Derry Office
Derry Medical Center
Overlook Park
6 Tsienneto Road
Derry, NH 03038
603.663.6549
Peterborough Office
Monadnock Community Hospital-Physician Consultants
454 Old Street
Peterborough, NH 03458
603.924.4646
Fax 603.924.4648
Nashua Office
St. Joseph’s Hospital-NEHI
166 Kinsley Street, Ste 301
Nashua, NH 03060
603.668.0127
Fax 603.598.3664