| Drug treatment of hyperlipidaemia: a guide to the rational use of lipid-lowering drugs. | |
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MedLine Citation:
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PMID: 20614945 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Mammalian sterol and lipid metabolism depends on a large number of highly evolved biochemical and histological processes responsible for the absorption, distribution and steady-state anabolic/catabolic handling of these substances. Lipoproteins are complex polymolecular assemblies comprising phospholipids, cholesterol and cholesterol esters, triglycerides and a variety of apolipoproteins. The primary function of lipoproteins is to facilitate the systemic distribution of sterols and lipids. Abnormalities in lipoprotein metabolism are quite common and are attributable to a large number of genetic mutations, metabolic derangements such as insulin resistance or thyroid dysfunction, and excess availability of cholesterol and fat from dietary sources. Dyslipidaemic states facilitate endothelial dysfunction and atherogenesis. Dyslipidaemia is recognized as a risk factor for cardiovascular disease in both men and women, and people of all racial and ethnic groups throughout the world. Dyslipidaemia is modifiable with dietary change and the use of medications that impact on lipid metabolism through a variety of mechanisms. Reducing atherogenic lipoprotein burden in serum is associated with significant and meaningful reductions in risk for a variety of cardiovascular endpoints, including myocardial infarction, ischaemic stroke, development of peripheral arterial disease and mortality. This review provides an overview on how to best position lipid-lowering drugs when attempting to normalize serum lipid profiles and reduce risk for cardiovascular disease. HMG-CoA reductase inhibitors (statins) are widely accepted to be the agents of choice for reducing serum levels of low-density lipoprotein cholesterol (LDL-C) in both the primary and secondary prevention settings. Ezetimibe and bile acid sequestrants are both effective agents for reducing LDL-C, either used alone or in combination with statins. The statins, fibric acid derivatives (fibrates) and niacin raise high-density lipoprotein cholesterol to different extents depending upon genetic and metabolic background. Fibrates, niacin and omega-3 fish oils are efficacious therapies for reducing serum triglycerides. Combinations of these drugs are frequently required for normalizing mixed forms of dyslipidaemia. |
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Authors:
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Peter P Toth |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Drugs Volume: 70 ISSN: 0012-6667 ISO Abbreviation: Drugs Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-09 Completed Date: 2010-10-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7600076 Medline TA: Drugs Country: New Zealand |
Other Details:
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Languages: eng Pagination: 1363-79 Citation Subset: IM |
Affiliation:
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Preventive Cardiology, Sterling Rock Falls Clinic, Sterling, Illinois 61081, USA. peter.toth@srfc.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antilipemic Agents
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therapeutic use* Cholesterol / metabolism Dyslipidemias / drug therapy Female Humans Hyperlipidemias / drug therapy* Lipoproteins / metabolism Male Triglycerides / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Antilipemic Agents; 0/Lipoproteins; 0/Triglycerides; 57-88-5/Cholesterol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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