Document Detail


The endocannabinoid system and cardiometabolic risk: effects of CB1 receptor blockade on lipid metabolism.
MedLine Citation:
PMID:  18715660     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiometabolic risk factors affect more than 47 million adults in the United States today. Although certain risk factors (e.g., obesity, dyslipidemia, hypertension, and hyperglycemia) contribute independently to the global risk, dyslipidemia is one of the most important risk factors for cardiovascular disease. Successful treatment requires a well-coordinated multifaceted approach, with commitment to a long-term program for disease management. Although initial attempts should focus on dietary changes and increased physical activity, most patients also need effective, safe, and well-monitored pharmacotherapy. Experimental studies have shown that overactivation of the endocannabinoid system-a physiologic signaling system involved in regulating energy intake, fatty acid synthesis and storage, and glucose and lipid metabolism-is associated with obesity, dyslipidemia, and insulin resistance. In clinical trials, selective blockade of CB1 receptors has resulted in substantial weight loss and significant improvement in lipid profiles. The effects of rimonabant, the first selective CB1 receptor blocker, were evaluated in 6600 obese or overweight adults who participated in one of 4 multicenter, placebo-controlled, randomized clinical trials for at least 1 year. Significant improvement in lipid profiles (specifically HDL and triglyceride levels and ratio of total cholesterol to HDL cholesterol) was seen in the 2503 patients taking rimonabant 20 mg/day, independent of its substantial effects on weight loss. No significant changes in LDL or total cholesterol were observed. Results of clinical trials with rimonabant are promising. Additional long-term controlled studies with appropriate follow-up are warranted to confirm the clinical potential of this drug, particularly its effects on dyslipidemia and other cardiovascular endpoints.
Authors:
Prakash Deedwania
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2008-08-19
Journal Detail:
Title:  International journal of cardiology     Volume:  131     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-12     Completed Date:  2009-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  305-12     Citation Subset:  IM    
Affiliation:
Cardiology Division, VACCHCS/UCSF School of Medicine, Fresno, San Francisco, California 93703, United States. deed@fresno.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / etiology*
Dyslipidemias / complications,  drug therapy,  etiology
Endocannabinoids / metabolism*
Humans
Insulin Resistance
Lipid Metabolism* / drug effects
Obesity / complications,  drug therapy,  etiology
Piperidines / therapeutic use
Pyrazoles / therapeutic use
Receptor, Cannabinoid, CB1 / antagonists & inhibitors*
Risk Factors
Signal Transduction
Chemical
Reg. No./Substance:
0/Endocannabinoids; 0/Piperidines; 0/Pyrazoles; 0/Receptor, Cannabinoid, CB1; 158681-13-1/rimonabant

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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