| Pharmacotherapy of disorders of plasma lipoprotein metabolism. | |
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MedLine Citation:
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PMID: 2203245 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pharmacologic intervention for altering plasma lipoproteins is aimed principally at reducing atherogenesis and thereby preventing coronary artery disease. These drugs should be prescribed only after nonpharmacologic interventions (reduction of saturated fat and cholesterol consumption, weight reduction, aerobic exercise, cessation of cigarette smoking) have failed to achieve an adequate effect. The plasma concentration of the atherogenic low-density lipoprotein (LDL) may be reduced in hypercholesterolemic patients by increasing hepatic LDL receptor synthesis (bile acid sequestering resins, 3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors) or by reducing hepatic very low density lipoprotein synthesis (gemfibrozil, nicotinic acid). LDL concentration may also be reduced by treatment with one of the fibrates (e.g., fenofibrate). Several classes of lipid-lowering drugs also increase the plasma high-density lipoprotein (HDL) cholesterol concentration. In the case of the fibrates, this appears to be principally mediated through an increase in lipoprotein lipase activity. Gemfibrozil additionally stimulates apolipoprotein AI synthesis. The increase in HDL cholesterol produced by nicotinic acid is due primarily to decreased clearance of HDL particles from the circulation. The increase in HDL concentration produced by gemfibrozil was shown in the Helsinki Heart Study to make a major contribution to a reduced incidence of coronary artery disease, independently of that made by the decrease in LDL. The Cholesterol-Lowering Atherosclerosis Study demonstrated that combined therapy with a resin (colestipol) and nicotinic acid can reduce the progression of coronary atherosclerosis and the development of graft lesions in patients who have undergone coronary artery bypass graft surgery. |
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Authors:
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N E Miller |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The American journal of cardiology Volume: 66 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1990 Sep |
Date Detail:
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Created Date: 1990-10-04 Completed Date: 1990-10-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 16A-19A Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27104. |
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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pharmacology,
therapeutic use* Apolipoproteins B / metabolism Humans Hyperlipoproteinemias / drug therapy* Lipoproteins, HDL / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Antilipemic Agents; 0/Apolipoproteins B; 0/Lipoproteins, HDL |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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