The Physician Experience

The impact of advanced testing on our nation’s future health

An interview with Dr. Tara Dall

By Dawn Thiselton, PhD, Senior Medical Writer/Editor, HDL, Inc.

Tara Dall, MD, is a board-certified clinical lipidologist, author, and educator with more than 10 years experience utilizing advanced lipid testing to detect risk for cardiovascular (CV) and metabolic disease. Her mission — to identify people at risk for CV disease and diabetes early in life — led her to open the first fully certified lipid clinic in the United States, Advanced Lipidology: Early Detection Center for Heart Disease and Diabetes, in Wisconsin.

From her earliest experiences as a family physician, Dr. Dall has witnessed the benefit of advanced lipid testing to thousands of patients. CV disease and diabetes are a significant cause of death globally, yet are largely preventable, if risk for developing them can be identified early enough. She highlights clinical trial data that has proven the importance of lipoprotein particles (e.g., ApoB, LDL particles) over LDL cholesterol in predicting CV risk, and explains, “So many people are unaware of their risk because the focus is still on cholesterol. Using advanced testing we can detect which young people have low- versus high-risk factors, then target high-risk individuals more aggressively with preventive therapies, while not overtreating those with, for instance, elevated cholesterol levels, but no other risk factors.”

One lesser known capability of advanced testing is the ability to detect lipoprotein changes associated with insulin resistance or metabolic syndrome, not otherwise easy to diagnose. This can open a window into diabetes risk years before abnormalities appear in glucose/HbA1c levels, so that with interventions like diet, exercise, and insulin sensitizers, diabetes can be prevented. Dr. Dall finds some easily overlooked biomarkers to be critical components of the HDL, Inc. panel: “I feel strongly that markers such as vitamin D and HbA1c are key to ruling out secondary causes of lipoprotein abnormalities. Vitamin D deficiency, as well as increasing risk for heart disease, can cause symptoms like muscle aches, fatigue, and depression, yet be easily corrected. This has tremendous clinical impact for individuals who need to tolerate a low-dose statin in order to reduce their CV risk.”

Dr. Dall believes that with the comprehensive HDL, Inc. advanced testing, a physician is unlikely to miss something clinically important. The opportunity to talk to an HDL, Inc. health coach, at no cost to patient or physician, supports doctors when interpreting test results and helps patients make the behavior changes required to lower their risk. By actively following the patient and interacting closely with the physician, a team approach is created to improving patient health. Dr. Dall has never seen a patient who had a CV event, without an abnormality revealed by advanced testing. This is critical, because only once the cause is ascertained can the problem be treated and future events prevented. As she points out, “Almost every abnormality indicated by biomarkers on the HDL, Inc. report is correctable, with dietary and lifestyle changes, or drug therapy. This gives the testing incredible value, and is especially satisfying from a provider standpoint as one can actually make a difference.”