| The management of hypercholesterolemia in patients with coronary artery disease: guidelines for primary care. | |
| | |
MedLine Citation:
|
PMID: 10682163 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
More than 10 million individuals in the United States currently have symptomatic coronary artery disease (CAD). Asymptomatic CAD is even more prevalent. CAD in the United States is responsible for approximately 1.5 million myocardial infarctions, 500,000 deaths, and a total economic burden in excess of $120 billion annually. Fortunately, CAD is preventable in many individuals. Our understanding of CAD has steadily progressed throughout the 20th century, and now several lines of evidence support the importance of cholesterol in both the genesis and management of coronary atherosclerosis. Following identification of the presence of cholesterol in atheromas, Anitschkov early this century demonstrated that atherosclerotic lesions can be induced in susceptible animals by high-saturated-fat and cholesterol diets. These lesions regressed when low-fat and cholesterol diets were resumed. In the 1970s and 1980s, findings from the landmark Framingham Heart, Seven Countries, and Multiple Risk Factor Intervention Trial studies firmly established that hypercholesterolemia was a major risk factor for cardiovascular morbidity and mortality. During the 1980s and 1990s, 21 of 22 angiographic trials demonstrated reduced progression of coronary and/or carotid artery disease using lifestyle, drug, and surgical means for reducing cholesterol. The later trials commonly employed hydroxymethylglutaryl coenzyme A reductase inhibitors (statins), reflecting increasing clinical use of these drugs. In 1988, the Adult Treatment Panel of the National Cholesterol Education Program (NCEP) published guidelines on testing and treating hypercholesterolemic patients, which outlined a more aggressive approach to cholesterol lowering than was currently in practice. Since 1994, five large cardiovascular event trials and a large angiographic trial have shown that aggressive cholesterol lowering reduces both cardiac morbidity and mortality, largely substantiating the NCEP guidelines. Although important clinical questions remain regarding patient subsets and treatment goals, lifestyle changes and appropriate drug therapy have proved to be highly effective in preventing initial and recurrent cardiovascular events. |
| | |
Authors:
|
R A Vogel |
Related Documents
:
|
3689483 - Progression and regression of human coronary atherosclerosis. the role of lipoproteins,... 20816133 - Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pre... 16461493 - Radiation dose levels during interventional cardiology procedures in a tertiary care ho... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Clinical cornerstone Volume: 1 ISSN: 1098-3597 ISO Abbreviation: Clin Cornerstone Publication Date: 1998 Jun-Jul |
Date Detail:
|
Created Date: 2000-03-16 Completed Date: 2000-03-16 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 9816002 Medline TA: Clin Cornerstone Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 51-64 Citation Subset: IM |
Affiliation:
|
Division of Cardiology, University of Maryland School of Medicine, Baltimore, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Clinical Protocols Clinical Trials as Topic Coronary Disease / complications* Humans Hypercholesterolemia / complications*, therapy* Primary Health Care |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Primary prevention of coronary disease.
Next Document: Pathogenesis of asthma.