Baltimore Lipid Center

Dr. Gregory Pokrywka, MD FACP FNLA FASPC NCMP

Our ServicesMeet Dr. Pokrywka

Baltimore Lipid Center Services

Focus on diagnosis and treatment of Lipid Disorders (cholesterol and triglycerides), Preventive Cardiology (prevention and treatment of atherosclerotic cardiovascular diseases such as heart attacks and strokes) and prevention and treatment of Dysmetabloic disease (e.g. diabetes and obesity)

Lipid Clinic Consultation Service

As the Baltimore area’s only Lipid Clinic specializing in women (men seen also!) and directed by an elected Fellow of the National Lipid Association/Fellow of the American Society for Preventive Cardiology/Board Certified Menopausal Practitioner, Baltimore Lipid Center is unique! Patients are seen by self and cardiologist/endocrinologist/ GYN/ pediatrician/ primary care doctor referral, from throughout the region. Onsite assessment of lab work and onsite ECAQ carotid imaging allows simple, state of the art risk assessment and management. Our on-site Board-certified Clinical Nutritionist consults on almost all patients (usually covered by insurance) . Common reasons for referral are second opinion about the treatment, statin intolerance/side effects, premature or severe family history of cardiovascular disease, diabetic and pre-diabetic cholesterol and triglyceride issues, very high cholesterol/triglyceride values, and progression of the disease (e.g. repeated cardiovascular events) on conventional therapies.

Primary Care

My primary care/internal medicine practice is a concierge practice. Build a closer relationship with your physician who can spend more time with you (instead of trying to see 30 patients per day). The annual fee is $1,500/year (unchanged since 2010). Advantages of this type of practice also include the ability to email the physician, the incredible help of Office Manager Kristen Evans to help guide you through specialist appointments, pre-ops, prior authorizations (and navigate the complex healthcare system in general), and 90-minute Annual Preventative Exam. 

Extra Cranial Atherosclerosis Quantification (ECAQ)

“ECAQ” is a simple in office ultrasound procedure to assess the presence of atherosclerotic plaque. This information is used to gauge the intensity of lipid (cholesterol and triglyceride) lowering therapy you need to reduce your heat attack and stroke. To find out more follow this link.

Menopausal Consultation Service

As a North American Menopause Society (NAMS) Certified Menopausal Clinician, Dr. Pokrywka is attuned to the unique medical issues of the last 40-50% of a woman’s life-the menopause. 

Medical Cannabis 

Dr. P has attended Md Medical Cannabis Committee meetings and provides Medical Cannabis advice and certification for official Maryland approved indications, which are chiefly chronic pain, PTSD, and anorexia/wasting syndromes. (Contrary to popular opinion, anxiety and insomnia are NOT approved indications in Maryland for medical cannabis)

Nutritional and Medical Weight Loss Consultation

Dr. P works with our on-site Board Certified Clinical Dietitian (usually covered by insurance) to assess your diet and leverage a nutritional and exercise program to reduce your risk for cardiovascular disease, diabetes, and if necessary obesity-related complications. We often utilize such concepts as “low-carb”, “intermittent fasting” and “time-restricted feeding”. Bariatric medications (“weight-loss meds”) are often utilized when needed, and referral for bariatric surgery can be done.

Opioid and Alcohol Treatment

Dr. P has treated addictions patients (opioid and alcohol) since 2010 and has been Medical Director at First Step Addictions Center. He utilized a “medically assisted therapy” approach, combining medications like sublingual suboxone and Vivitrol injections, with mandatory counseling and on-site drug testing. This part of the practice is “cash-only” as insurance plans pay little or nothing for this type of treatment but WILL cover the medications. 

Cardiovascular disease is the leading cause of death and a reduction in quality of life in the United States. It is often preventable. Dr. Pokrywka is a National thought leader in the prevention of cardiovascular disease, and has published and lectured extensively coast to coast on the topics of advanced cholesterol/lipoprotein testing, prevention of cardiovascular disease and diabetes, and focuses (not exclusively) on Menopausal women and the above problems. We always encourage aggressive lifestyle changes first and use appropriate medications next when indicated.

https://www.ncbi.nlm.nih.gov/pubmed/34665804
Nice to know our publication on hi trigs is helping Schnauzers ! 🙂 ("Supplementation of omega-3 and dietary factors can influence the cholesterolemia and triglyceridemia in hyperlipidemic Schnauzer dogs: A preliminary report"

Dr. Oz Hopes to Replace Rand Paul as Biggest Quack in Senate | The New Yorker https://www.newyorker.com/humor/borowitz-report/dr-oz-hopes-to-replace-rand-paul-as-biggest-quack-in-senate?utm_source=nl&utm_brand=tny&utm_mailing=TNY_Borowitz_120121&utm_campaign=aud-dev&utm_medium=email&bxid=5bea0ecd2ddf9c72dc8e7ec0&cndid=24492313&hasha=6f10784c96b4e973d5c283432e966660&hashb=a68790a99ef07420b7b4352c92cd0a8e59f688c8&hashc=4470c94d84e9a53af317c144c0cea793694f1511826f29449f169363072ec26e&esrc=NYR_BOROWITZ_BLOG&mbid=mbid%3DCRMNYR012019&utm_term=TNY_Borowitz

All vaccinated adults should get a Covid-19 booster shot because of the Omicron variant, CDC says - CNN https://www.cnn.com/2021/11/29/health/cdc-booster-guidance-omicron/index.html?utm_term=1638272454579729c9c5a3417&utm_source=cnn_Five+Things+for+Tuesday%2C+November+30%2C+2021Pandemic+...+Supply+chain+...+China+...+Barbados+...+Twitter&utm_medium=email&bt_ee=ICBmY6G9hZRs8it6zrdscllAIBwA1cpMor7fcNUFEGVJJV161RssDlwJby6EGprG&bt_ts=1638272454582

Why it's important to vaccinate children against COVID | Office for Science and Society - McGill University https://www.mcgill.ca/oss/article/covid-19/why-its-important-vaccinate-children-against-covid

What to know about the omicron variant, a new Covid-19 mutation - Vox https://www.vox.com/2021/11/27/22804556/omicron-variant-covid-19-south-africa-explained

Daryl Austin: Covid vaccine resistance is nothing new. Anti-vaxxers are as old as vaxxing itself. https://www.nbcnews.com/think/opinion/covid-vaccine-resistance-nothing-new-anti-vaxxers-are-old-vaxxing-ncna1284828

Opinion | Will you fall into the conspiracy theory rabbit hole? Take our quiz and find out. - Washington Post https://www.washingtonpost.com/opinions/interactive/2021/conspiracy-theory-quiz/

A Game Plan for Healthy Enjoyment of the Holidays - Peter Attia https://peterattiamd.com/a-game-plan-for-healthy-enjoyment-of-the-holidays/?utm_source=weekly-newsletter&utm_medium=email&utm_campaign=211121-NL-thanksgiving&utm_content=211121-NL-thanksgiving-email-subs

This, if you are having acute #Omicron anxiety: "It may be it's highly transmissible, but so far the cases we are seeing are extremely mild," Angelique Coetzee, chair of the South African Medical Association -https://www.businessinsider.com/omicron-coronavirus-variant-cases-mild-south-africa-2021-11

Keep calm, stay informed.

If you're kicking off holiday shopping this #blackfriday or #cybermonday, set Vaccinate Your Family as your charity of choice on #amazonsmile to give back to vaccine education & awareness while you shop! https://smile.amazon.com/ch/52-2165100

HeartHealth Tip of the Day:
Statins not only slow cognitive decline and reduce the risk dementia but also decrease hospitalization rates as much as 25% in men and women with a history of major depression.

So much data not supporting PCI over OMT in IHD management yet we somehow don’t believe in medical therapy. #ASPCCongress2019 @ASPCardio #aspcexpertscourse @dramitkhera @SamRRazaMD @SethJBaumMD @SethShayMartin @RonBlankstein

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MUST READ - Official AHA Statement on Lp(a) - endorsed by @atherosociety Call and demand that your lab reports the concentration in nmol/L - stop accepting the value in mg/dL (conversion of which is inaccurate). https://www.ahajournals.org/doi/pdf/10.1161/ATV.0000000000000147 @society_eas

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Study found that a sizeable proportion of obstructive coronary artery disease occurred among younger patients without coronary artery calcium https://ja.ma/3k1Od4j

As always the weekly e-mails by @PeterAttiaMD are worth a read https://peterattiamd.com/does-fish-oil-cause-cardiac-arrhythmia/?utm_source=weekly-newsletter&utm_medium=email&utm_campaign=211107-NL-fishoil&utm_content=211107-NL-fishoil-email

I hope my graphics help explain that Non-HDL-C (more accurately called apoB-cholesterol) serves as a calculated (free - apart from cost of lipid profile) surrogate estimate of the all important apoB concentration. Non-HDL-C, it is commonly used as a secondary goal of therapy

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Important open access review in Current Opinions In Lipidology discussing the family of angiopoietin-like proteins (including ANGPTL3) as a therapeutic target. Improving lipids and lipoproteins via alteration of lipases https://pubmed.ncbi.nlm.nih.gov/34581310/

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Henry Pownal et al gem! Efflux of free cholesterol (FC) from tissues, including arterial wall macrophages is reversible. Dysfunctional HDL may contribute to ASCVD by sending FC back into plaque macrophages. Over time, this may produce a high ASCVD risk https://www.nature.com/articles/s41569-021-00538-z.pdf

Niacin⬆️HDLc & ⬇️LDLc, VLDLc & Lp(a). Yet in ASCVD pts
adding niacin to statins⬆️the risk of serious adversity & no⬇️in MACE, despite⬆️HDLc & did not reduce all-cause or ASCVD mortality. NIACIN HAS NOT LIVED up to its promise in the prevention of ASCVD https://www.nature.com/articles/s41569-021-00538-z.pdf

"We need to shift lipid levels closer to those of healthy babies & redefine the norm closer to what is biologically normal." See FOS study & then the editorial by @ErinMichos & @SethShayMartin https://pubmed.ncbi.nlm.nih.gov/25623155/ https://pubmed.ncbi.nlm.nih.gov/25623154/

Nice chance to learn much about the lipidome - https://www.bigmarker.com/eas-society/Aligning-plasma-lipidomics-and-metabolic-studies-in-lipid-metabolism?show_live_page=true

In cohort study of >389K pts, risk of MI was best captured by # apoB-particles, independent from lipid content (cholesterol or TG) supporting that apoB is the primary driver of atherosclerosis & lowering apoB should be the focus of therapy https://pubmed.ncbi.nlm.nih.gov/34773460/

Coronavirus FAQ: What is long COVID? And what is my risk of getting it? ( the best way to prevent "long covid " is to GET VACCINATED !) https://www.npr.org/sections/goatsandsoda/2021/11/18/1055071699/coronavirus-faq-what-is-long-covid-and-what-is-my-risk-of-getting-it?sc=18&f=1001

Has The Warranty Period for a Coronary Calcium Score of Zero Been Revoked? https://theskepticalcardiologist.com/2021/11/10/has-the-warranty-period-for-a-coronary-calcium-score-of-zero-been-revoked/ via @skepcard

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