Thread by @DBelardoMD

Working with registered dietitians has been INCREDIBLE for my patients care. Especially my patients who are statin hesitant.

...And not just in the way you would expect.

A thread about our telehealth RD @KCKlatt and how he’s impacted our patients care 🧵

Having an RD affiliated with your practice that you can send patients to is incredibly valuable.
As a cardiologist who cares extraordinarily about prevention, whether it’s seeing patients in primary prevention who have hyperlipidemia, diabetes, hypertension, and trying to reduce

their risk for developing for ASCVD, or whether seeing my patients who have established CAD and we are trying to reduce their risk for future cardiovascular events, nutrition ALWAYS plays a part of the equation.

But so does guideline directed medical therapy. And sometimes, unfortunately, these are put at odds against one another by proponents on social media.

So when I see my patients who meet guideline criteria for statin therapy for either primary or secondary prevention, I always remind them, it’s not either or: diet or medicine. It should be both.
But there is what feels like a growing anti-statin movement.

Despite being one of the most studied medications, that is incredibly effective and inexpensive, it’s unfortunately demonized often by the “Food as Medicine” crowd. And this is where my RD makes one of the biggest impacts: helping to reinforce the power of GDMT.

In normal work flow, we see a patient, recommend both dietary and lifestyle changes, and when indicated, GDMT. And if possible, they see our RD to help with dietary interventions to further reduce their cardiovascular risk.

But even more impactful lately has been the opposite: by sheer luck of scheduling, some patients are a bit hesitant about statins have been scheduled to see our RD *first*. He emphasizes all of the dietary changes that can help reduce lipids, cardio metabolic health, DM, and HTN.

But maybe most importantly... @KCKlatt presents the patients with the limitations of nutrition too!

By the time the patient comes to see me, they are already armed with evidence based nutrition knowledge, the incredible power of dietary interventions, in addition to their limitations, and they are primed for guideline directed medical therapy if needed.

This kind of education has been unbelievably beneficial in our patients. I’m so appreciative of @KCKlatt for helping our patients to understand that both guideline directed medical therapy, and nutrition/lifestyle intervention are both powerful tools in optimizing their health.

So, moral of the story is, sometimes the people who might help our statin hesitant patients feel most comfortable initiating GDMT are not the cardiologists, sometimes it’s the dietitian! ❤️