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Lipid Lowering (lipid + lowering)
Terms modified by Lipid Lowering Selected AbstractsCardiovascular Events in Hypertension Trials of Angiotensin-Converting Enzyme InhibitorsJOURNAL OF CLINICAL HYPERTENSION, Issue 2005William J. Elliott MD Angiotensin-converting enzyme inhibitors are widely-prescribed drugs for hypertension and are supported by clinical trials in which they reduce cardiovascular events. In the high-risk patients in the Heart Outcomes Prevention Evaluation, the Perindopril Protection Against Recurrent Stroke Study, and European Trial of Reduction of Cardiac Events With Perindopril in Stable Coronary Artery Disease, ramipril and perindopril showed impressive benefits. One reason trandolapril did somewhat less well in the Prevention of Events With Angiotensin-Converting Enzyme Inhibition trial may be that its patients were very well treated with other effective modalities. In the Antihypertensive and Lipid Lowering to Prevent Heart Attack Trial, lisinopril-treated patients had a slightly lower incidence of myocardial infarction, despite much poorer control of blood pressure, perhaps because a second-line diuretic was prohibited by protocol. Although angiotensin-converting enzyme inhibitors can cause cough and angioedema (more common among blacks), angiotensin receptor blockers are currently more expensive and have fewer outcome trials to support their use. [source] Preventive Cardiology: More than Just Lipid LoweringPREVENTIVE CARDIOLOGY, Issue 3 2001Edward D. Frohlich MD No abstract is available for this article. [source] Development of the Thyroid Hormone Receptor ,-Subtype Agonist KB-141 : A Strategy for Body Weight Reduction and Lipid Lowering with Minimal Cardiac Side EffectsCARDIOVASCULAR THERAPEUTICS, Issue 2 2005Gary J. Grover ABSTRACT Few treatments for obesity exist and improvements for treatment of hyperlipidemia are still desirable. Thyroid hormone receptors (TRs) regulate body weight, adiposity, and cholesterol levels. However, thyroid hormones can have deleterious effects, particularly cardiac acceleration, that limits the use of hormones in the treatment of obesity. There is evidence that the TR, subtype mediates lowering of blood cholesterol levels and possibly elevation of metabolic rate, whereas TR, appears to control heart rate. In studies, described in this review article, we examined the effects of selective TR, activation on metabolic rate and heart rate in mice, rats and monkeys. T3 had a greater effect on increasing heart rate in wild type (WT) than in TR,-/- mice (ED15 values of 34 and 469 nmol/kg/day, respectively). T3 increased metabolic rate (MVO2) in both WT and TR,-/- mice, but the effect on TR,-/- mice was less pronounced compared to WT mice. Stimulation of MVO2 is mediated by both TR, and TR,, but with different profiles. In cholesterol-fed rats, KB-141, a selective TR, agonist, increased MVO2 with a 10-fold selectivity and lowered cholesterol with a 27-fold selectivity vs. tachycardia. In primates, KB-141 caused significant, cholesterol, Lp(a) and body weight reduction after 1 week of treatment with no effect on heart rate. These data suggest that selective TR, agonists may represent a novel class of drugs for the treatment of obesity, hypercholesterolemia and elevated Lp(a), which may make them useful therapeutics for patients with metabolic syndrome. [source] Lipid lowering and recurrent stroke: a definitive answer?INTERNATIONAL JOURNAL OF STROKE, Issue 2 2007Pierre Amarenco No abstract is available for this article. [source] Genetic influence in antithrombotic actions of atorvastatin in hypercholesterolaemiaEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2008L. Puccetti ABSTRACT Background, Recent data indicate that statins could offer coronary artery disease (CAD) benefit even by mechanisms beyond lipid lowering. Genetic influence has been shown for some antithrombotic actions of statins via oxidized-low-density lipoprotein cholesterol (ox-LDL) receptors and nitric oxide synthase (NOS) activity modulation. The present study was designed to evaluate the influence of ox-LDL lectin-like receptor-1 (LOX-1) and NOS polymorphisms in the incidence of cardiovascular events in pure hypercholesterolaemic subjects during statin treatment. Materials and methods, A prospective 4-year study involving 1039 event-free subjects (643 males, 396 females) treated with atorvastatin (10,40 mg day,1) to reach the appropriate Adult Treatment Panel-III LDL target of 3·36 mmol L,1. Enrolled subjects were evaluated every 6 months or at a clinical event. LOX-1 3,UTR/T-C and NOS G894T polymorphisms were detected by allelic discrimination assays (polymerase chain reaction), lipid profile by enzymatic-colorimetric method, ox-LDL by enzyme linked immunosorbent assay, platelet activation by P-selectin (P-sel) expression (FACScan), NOS activity (by intracellular citrullin recovery) and homocysteine (high performance liquid chromatography), C-reactive protein (CRP) by sensitive nephelometric technique. Results, LOX-1 3,UTR/T showed the strongest association with events in the whole cohort with respect to each other variable including LDL reduction and NOS G894T (OR 4·90, 95% CI 3·19,6·98, P < 0·00001). Smoking influenced events in LDL-targeted subjects (P < 0·0001). Ox-LDL and P-sel were better indicators than LDL or other variables according to 3,UTR/C genotype regardless of the magnitude of LDL reduction (OR 4·21, 95% CI 2·29,6·70 P < 0·0001). Conclusions, LOX-1 polymorphisms could influence statin effectiveness in CAD prevention by induction of sensitivity to antithrombotic mechanisms such as antiplatelet activity. [source] Pecan Effects on Serum Lipoproteins and Dietary Intakes of Hyperlipidemic Individuals Consuming Self-Selected DietsFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 3 2005Wanda A. Eastman Pecan-supplemented diets were studied in 17 hyperlipidemic individuals who were randomly assigned to pecan (6 women, 2 men, age 46±6 years [mean±SD]) or control (7 women, 2 men, age 53±10 years). The pecan group consumed 68g of pecans/day for 8 weeks. Total fat, monounsaturated fat, and polyunsaturated fat intakes were significantly higher in the pecan group. LDL cholesterol was lowered in the pecan group from 152±21 mg/dL at entrance to 136±22 at Week 4 but was 153±33 by Week 8. LDL cholesterol was significantly lower in the pecan group than controls at Week 4 (136±22 mg/dL versus 173±60). Total cholesterol in the pecan group was 233±19 mg/dL at entrance and 221±18 by Week 4 but was 232±35 by Week 8. Total cholesterol was significantly lower in the pecan group (221±18 mg/dL) than controls (257±60) at Week 4. Pecans in diets of hyperlipidemic individuals did not have sustained serum lipid lowering. [source] A study of dietary advice and care provided to HIV positive patients referred for lipid lowering: as part of a service improvement initiativeJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2008N.A. Billing Background:, Combination antiretroviral therapy (ART) has dramatically reduced mortality in HIV-infected patients. As life expectancy of HIV infected patients has increased, concerns about the long-term effects of treatment grow (Sax, 2006). HIV positive patients have a greater risk of myocardial infarction (MI) and ART has been associated with a 26% increase in the rate of MI per year of exposure (DAD Study Group, 2003). The aim of this study was to evaluate provision of dietetic care to patients referred for lipid lowering advice and identify potential areas for service improvement. Methods:, Departmental activity statistics identified 117 new clients referred for lipid lowering advice in the previous 11 months. The biochemical data and dietetic record cards were screened, of the initial sample 30 were excluded as they did not have follow up biochemistry after their dietetic consultation and a further seven were excluded as they were seen primarily for other conditions. The remaining cards (n = 80) had their dietetic record cards audited to check dietary topics discussed, risk factors identified length before follow up and clinical outcomes. Results:, There were 68 men and 12 women in this sample with a mean age of 46 years and mean body mass index (BMI) of 25.4 kg m,2 (3.7 kg m,2). Of the clients referred, only 48.8% of the sample had high density lipoprotein (HDL): cholesterol ratios taken to calculate cardiovascular risk and most patients were seen an average of 30.7 days (35.3 days) after high was identified. Following their dietetic consultation, 77% of clients had a reduction in their cholesterol levels and 61% had a reduction in triglyceride levels. This sample's average percentage change in cholesterol was ,10% (16%) and triglyceride was ,6% (32%). The most popular dietary advice was reducing saturated fat intake (90%), increasing fibre intake (76%), benefits of plant stanols (40%), importance of regular meals (29%), exercise (26%) and benefits of omega three (11%). Additional risk factors identified 11% of clients seen were smokers, however most records (66%) did not have documentation on whether smoking behaviour was discussed. Only 20% of clients had a follow up appointments and not all were seen within 3 months with average time between follow up being 14.9 weeks (13.2 weeks). Discussion:, Improvement in biochemical results were comparable to a study by Henry et al., (1998) which showed that in HIV infected clients receiving ART, diet modification and increased exercise were successful in reducing cholesterol levels by 11% and triglyceride levels by 21%. The level of smoking was considerably lower than other studies (DAD Study Group, 2003) which reported 56% of HIV positive clients to be smokers. A large number of clients were lost to follow up and were not seen within 3 months. Lazzaretti et al., (2007) showed in a randomized trial that seeing patients at regular 3 month intervals for dietary intervention prevented an increase in lipid blood levels in individuals who start ART. Conclusions:, Not all clients are having their cardiovascular risk calculated before referral for dietary advice. Clients are not being seen at regular intervals by dietitians, some are lost to follow up and smoking status is not regularly documented during dietetic consultation. References, Data Collection on Adverse Events of Anti-HIV Drugs (DAD) Study Group. (2003) Combination antiretroviral therapy and the risk of myocardial infarction. N. Engl. J. Med.349, 1993,2003. Friis-Moller, N., Weber, R., Reiss, P., Thiebaut, R., Kirk, O., d'Arminio, M.A. et al. (2003) Cardiovascular disease risk factors in HIV patients' association with antiretroviral therapy. Results from the DAD study. AIDS17, 1179,1193. Henry, K., Melroe, H., Huebesch, J., Hermundson, J. & Simpson, J. (1998) Atorvastatin and gemfibrozil for protease inhibitor-related lipid abnormalities. Lancet352, 1031,1032. Sax, P.E. (2006)Strategies for management and treatment of dyslipidemia in HIV/AIDS. AIDS Care 18, 149,157. Lazzaretti, R., Pinto-Ribeiro, J., Kummer, R., Polanczyk, C. & Sprinz, E. (2007) Dietary intervention when starting HAART prevents the increase in lipids independently of drug regimen: a randomized trial. Oral abstract session: 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention: Abstract no.WEAB303. [source] Improving Compliance in Your Dyslipidemic Patient: An Evidence-based ApproachJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2001Diane M. Becker RN Purpose To synthesize the evidence from landmark clinical studies of lipid-lowering pharma-cotherapy and nurse management of hyperlipidemia, discuss issues related to nonadherence, and proposes strategies for achieving long-term cholesterol control. Data Sources All publications of lipid-lowering clinical trials related to pharmacotherapy for dyslipidemias were accessed from a thorough Medline Search and reviewed by two nurse experts. Conclusions Randomized controlled studies provide com-pelling evidence that reduction of blood cho-lesterol with pharmacotherapy reduces both first and subsequent coronary events. Nonetheless, inadequate provider and patient adherence to guidelines for lipid lowering remains prevalent. Studies show that nurses provide safe and effective care for patients with abnormal lipids. Implications This article assists nurse practitioners in playing an active role in the implementation of the National Cholesterol Education Program Adult Treatment Panel III Report to be released in Spring 2001, where a strong emphasis will be placed on multidisciplinary approaches and adherence. [source] Effect of hesperidin and naringin on the plasma lipid profile and plasma antioxidant activity in rats fed a cholesterol-containing dietJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 7 2007Shela Gorinstein Abstract The objective of this study was to compare the influence of hesperidin and naringin, the main flavonones of orange and grapefruit, on plasma lipid profile and antioxidant activity in rats fed a cholesterol-containing diet. Sixty male Wistar rats were randomly divided into six groups of 10, named Control, Hesperidin, Naringin, Chol, Chol/Hesperidin and Chol/Naringin. The Control group was fed a basal diet (BD) and 1,2 mL of distilled water. To the BD of the other five groups were added 0.1,0.2 mg of hesperidin dissolved in 1,2 mL of distilled water (Hesperidin group), 0.46,0.92 mg of naringin in 1,2 mL of water (Naringin group), 1% of non-oxidised cholesterol (NOC) and 1,2 mL of water (Chol), 1% of NOC and 0.1,0.2 mg of hesperidin in 1,2 mL of water (Chol/Hesperidin), 1% of NOC and 0.46,0.92 mg of naringin in 1,2 mL of water (Chol/Naringin). After 30 days of the experiment it was found that the diets supplemented with hesperidin and naringin increased the plasma antioxidant activity. In conclusion, diets supplemented with hesperidin and naringin significantly hindered the increase in plasma lipid levels caused by cholesterol feeding. Hesperidin and naringin, bioactive compounds of citrus fruits, are powerful plasma lipid lowering and plasma antioxidant activity increasing flavonones. Copyright © 2007 Society of Chemical Industry [source] Understanding risk in hypercholesterolemiaCLINICAL CARDIOLOGY, Issue S1 2003John C. Larosa M.D. President Abstract Atherosclerosis was relatively uncommon 100 years ago, when researchers first established its link to elevated cholesterol. As the twentieth century progressed, however, factors such as high-fat diets, sedentary lifestyles, cigarette smoking, and urbanization combined to increase the prevalence of both hypercholesterolemia and coronary heart disease (CHD) throughout the developed world. Atherogenesis begins at an early age and progresses throughout life, and cholesterol levels during young adulthood strongly predict the risk of CHD and related mortality during the ensuing decades. The total cholesterol level in youth also determines the actual age at which a critical level of atherosclerosis will be reached. Early studies on the primary and secondary prevention of CHD failed to identify a linear relationship between lipid lowering and risk reduction, primarily because older lipid-lowering agents lacked the potency to reduce cholesterol levels significantly enough to achieve lower cardiovascular event and mortality rates. The introduction of the statins, with their powerful lipid-lowering activity, overcame this limitation. Several large-scale trials of statins firmly established the efficacy of these agents in both primary and secondary CHD prevention. With the availability of statin therapy, we are now able to reduce the risk of major adverse CHD events by an average of 30%, regardless of patient age or gender. [source] | ||||||||||