Document Detail


Advancing therapy for hypercholesterolemia.
MedLine Citation:
PMID:  20509773     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
IMPORTANCE OF THE FIELD: Hypercholesterolemia holds a key role in the development and progression of atherosclerosis and is a causative factor of coronary artery disease. Current guidelines for cholesterol treatment target low-density cholesterol (LDL-C) as the primary goal of therapy. Despite advances in the pharmacotherapy of atherosclerosis, the most successful agents used to treat this disease--HMG CoA reductase inhibitors--remain ineffective for the primary or secondary prevention of myocardial infarction in 50-60% of patients. Advancing therapy for hypercholesterolemia with new-emerging drugs either as monotherapy or in combination will hopefully improve cardiovascular outcomes.
AREAS COVERED IN THIS REVIEW: The two major sources of cholesterol in the human body are: i) biosynthesis of cholesterol by the liver; and ii) absorption by the intestines. Both play a pivotal role in the overall balance of cholesterol. A recent and more effective therapeutic strategy is to treat both sources of cholesterol simultaneously with a complementary mechanism of action. The present article presents cholesterol metabolism and reviews new emerging lipid-lowering drugs and therapies that: i) lower LDL-C; ii) lower triglycerides; and iii) increase high-density lipoprotein cholesterol.
WHAT THE READER WILL GAIN: This review summarizes the pivotal role of both the liver and intestine in the overall balance of cholesterol in the body and describe the clinical impact and relevance of using new emerging lipid-lowering drugs either alone or co-administered with statins in controlling cholesterol levels.
TAKE-HOME MESSAGE: An elevated concentration of LDL-C plays a causal role in the development of cardiovascular disease. The new aggressive cholesterol treatment goals call for a more advanced therapeutic approach to maximize the cardiovascular benefits associated with lower LDL-C levels.
Authors:
Konstantinos Toutouzas; Maria Drakopoulou; Ioannis Skoumas; Christodoulos Stefanadis
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  11     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-08-02     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  1659-72     Citation Subset:  IM    
Affiliation:
Medical School of Athens University, Hippokration Hospital, First Department of Cardiology, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Azetidines / therapeutic use
Bile Acids and Salts / metabolism
Carrier Proteins / antagonists & inhibitors
Cholesterol / biosynthesis
Cholesterol Ester Transfer Proteins / antagonists & inhibitors
Cholesterol, LDL / blood
Farnesyl-Diphosphate Farnesyltransferase / antagonists & inhibitors
Fatty Acids, Omega-3 / therapeutic use
Fenofibrate / therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Hypercholesterolemia / drug therapy*
Intestinal Absorption
Niacin / therapeutic use
Chemical
Reg. No./Substance:
0/Azetidines; 0/Bile Acids and Salts; 0/Carrier Proteins; 0/Cholesterol Ester Transfer Proteins; 0/Cholesterol, LDL; 0/Fatty Acids, Omega-3; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/microsomal triglyceride transfer protein; 163222-33-1/ezetimibe; 49562-28-9/Fenofibrate; 57-88-5/Cholesterol; 59-67-6/Niacin; EC 2.5.1.21/Farnesyl-Diphosphate Farnesyltransferase

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