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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One international and numerous national bodies have adopted action limits and guidelines for diagnosis and treatment of hyperlipidemia. The most publicized are those adopted by the European Atherosclerosis Society and by the National Cholesterol Education Program in the USA. Although differing in details, these guidelines share fairly low action limits based on observational epidemiology demonstrating increasing risk of cardiovascular disease in persons with serum cholesterol concentrations over 4-5 mmol/L. Various national bodies within Europe have adopted similar guidelines. In other countries, higher and therefore more conservative action limits have been proposed. They are primarily based on results of intervention studies. Seemingly small, differences between action limits may encompass a large part of the population.
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PMID:Action limits in hyperlipidemia. 218 11

An increased platelet-vessel wall interaction plays an important role in most forms of cardiovascular disease. In healthy arteries, the vascular endothelium prevents platelet adhesion and aggregation. As a mediator of this protective function, the endothelium produces prostacyclin, endothelium-derived nitric oxide and tissue plasminogen activator. Cardiovascular risk factors such as hypertension, hyperlipidemia and diabetes are associated with an increased platelet activation and with decreased antithrombotic properties of the blood vessel wall. The available inhibitors of platelet function interfere only with one of various mechanisms of platelet activation and of the platelet-vessel wall interaction. Prostaglandin inhibitors, such as aspirin and newer, more specific inhibitors, prevent the production and/or the effect of thromboxane A2 on platelets and the blood vessel wall. Other drugs interfere with the effect of adenosine diphosphate on platelets, or they increase intracellular concentration of cyclic GMP or AMP in platelets and vascular smooth muscle cells. The protective effects of platelet inhibitors in primary and particularly in secondary prevention of cardiovascular diseases have been documented in numerous studies. The successful clinical use of these substances, however, requires a selective prescription of the drugs in patients with cardiovascular disease.
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PMID:[Thrombocyte inhibitors in cardiovascular therapy]. 221 49

The JCR:LA-cp rat is a strain incorporating the corpulent (cp) gene. When homozygous for the cp gene, the rats are hyperphagous, hyperinsulinemic, hyperlipidemic and obese. The corpulent male rats develop atherosclerotic and myocardial lesions from an early age, while corpulent female and lean rats do not develop lesions. The hyperlipidemia is due to elevated levels of VLDL resulting in moderately raised cholesterol levels and markedly elevated triacylglycerol levels. The VLDL concentrations are similar in corpulent male and female rats at an early age with both having much higher levels than lean rats. As the animals age, the VLDL hyperlipidemia in the corpulent male increases at 3 months and then decreases slowly and rises again at 12 months of age. The corpulent female rats show higher triacylglycerol and phospholipid concentrations than the males at 3 months age and reach values over 1000 mg/100 ml by 9 months of age, then decrease at 12 months of age. The cholesterol concentrations of the corpulent females are greater than those of the males from 9 months of age. Thus, in the period of life up to middle age, the cardiovascular disease incidence does not correlate with the degree of hyperlipidemia. The disease progression does correlate with the severity of insulin resistance and glucose intolerance, which is more severe in the corpulent male than female rats. The results suggest that the hyperlipidemia must be a necessary condition for development of atherosclerotic disease in this strain of rats, but it is not a sufficient condition.
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PMID:Effect of age on serum lipids and lipoproteins of male and female JCR:LA-corpulent rats. 229 27

Cardiovascular disease is a frequent cause of morbidity and mortality following renal transplantation. The percentage of deaths due to ischemic cardiovascular disease and cerebrovascular accidents nearly equals that caused by infection among patients receiving their first transplant, according to data from the European Dialysis and Transplant Association Registry. Hypercholesterolemia is a risk factor for cardiovascular disease frequently identified following renal transplantation, and diets low in fat and cholesterol have been suggested as treatment. Previous studies have not reported the response of LDL cholesterol to dietary treatment, and it is this form of cholesterol that is most closely related to cardiovascular disease. The American Heart Association has provided nutritionists with guidelines for the treatment of hyperlipidemic patients which include the Step One Diet. Previous dietary studies of renal transplant recipients have allowed a slightly higher intake of fat than that currently recommended by the AHA. We wondered if an easily reproducible diet well known to nutritionists such as the AHA Step One Diet would be effective in lowering cholesterol levels in hyperlipidemic renal transplant recipients. The purpose of our study was not to define the mechanisms of posttransplant hyperlipidemia, but rather to assess the effectiveness of dietary intervention on hyperlipidemia following renal transplantation.
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PMID:The effect of the American Heart Association step one diet on hyperlipidemia following renal transplantation. 230 Oct 29

Familial defective apolipoprotein B-100 (FDB) is a recently identified, dominantly inherited genetic disorder, which leads to increased serum concentration of low density lipoprotein (LDL) cholesterol with reduced affinity for the LDL receptor. This disorder is associated with a G to A mutation in exon 26 of the apolipoprotein B (apo B) gene which creates a substitution of glutamine for arginine in the codon for amino acid 3500. We have searched for this mutation in 374 unrelated individuals with hyperlipidaemia from the United Kingdom, and in 371 unrelated individuals with a primary clinical diagnosis of atherosclerosis from the United Kingdom and Scandinavia. Ten individuals, 9 from the U.K. and 1 from Denmark, were identified. The frequency of the mutation was 3% in individuals classified clinically as having familial hypercholesterolaemia (FH) and 3% in individuals with type IIa hyperlipidaemia without FH, and was not found in patients with types IIb and III hyperlipidaemia. The mutation was rare in individuals with a primary clinical diagnosis of atherosclerosis. Plasma lipid levels and clinical characteristics of the ten patients identified in the present study are similar to those reported for heterozygous FH. Thus, in our study, FDB is associated with moderate to severe hypercholesterolaemia, and appears to be a serious disorder causing premature cardiovascular disease. Individuals with this mutation can be identified unambiguously using routine molecular screening techniques.
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PMID:Familial defective apolipoprotein B-100: detection in the United Kingdom and Scandinavia, and clinical characteristics of ten cases. 231 Apr 29

Heart disease is the leading cause of mortality and a major cause of morbidity in women in the United States. Premenopausal and postmenopausal risk factors for cardiac disease must be reduced to protect women from this major health hazard. The main coronary risk factors for premenopausal women are hypertension, smoking, hyperlipidemia, obesity, and diabetes. Postmenopausal women have these risk factors in addition to a lack of estrogen. Most studies have shown that replacing estrogen in the menopausal woman reduces cardiovascular disease, probably by increasing HDL and decreasing LDL.
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PMID:Protecting older women from their growing risk of cardiac disease. 233 76

The relationship between corneal arcus (arcus senilis) and mortality from coronary heart disease (CHD) and cardiovascular disease (CVD) is examined in a prospective study of White men (n = 3,930) and women non-hormone users (n = 2,139), ages 30-69, followed for an average of 8.4 years as part of the Lipid Research Clinics Mortality Follow-up Study. After excluding those with clinically manifest CHD at baseline, corneal arcus was strongly associated with CHD and CVD mortality only in hyperlipidemic men ages 30-49 years, for whom the relative risk for CHD and CVD death was 3.7 and 4.0, respectively, after adjusting for age, total cholesterol, HDL cholesterol, and smoking status using a Cox proportional hazards model. Among 30-49 year old males, corneal arcus appears to be a prognostic factor for CHD, independent of its association with hyperlipidemia in this age-group, of about the same magnitude as other common risk factors, underscoring the usefulness of corneal arcus as a prognostic factor to the practicing clinician.
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PMID:The association of corneal arcus with coronary heart disease and cardiovascular disease mortality in the Lipid Research Clinics Mortality Follow-up Study. 240 23

The importance of hypertension and hyperlipidemia as independent and interactive risk factors for the development of premature cardiovascular disease, and particularly for the development of atherosclerotic coronary heart disease, is becoming increasingly apparent both from epidemiologic data and from therapeutic trials. Nevertheless, therapeutic trials of patients with mild hypertension have not demonstrated benefits from lowering arterial pressure, in terms of reduced mortality rates from coronary events. This may, in part, be due to the fact that many of the antihypertensive agents used in these trials adversely influence lipid and lipoprotein levels. Thus, agents that are lipid-neutral or that favorably influence the lipid profile, such as selective alpha 1-inhibitors, are receiving increasing attention for the treatment of mild hypertension. Recent insights into these issues are considered.
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PMID:Selective alpha 1-adrenergic blockade, lipids, and coronary heart disease risk. Considerations in the treatment of mild hypertension. 256 24

Patients on chronic hemodialysis often present both hyperlipidemia and a high incidence of cardiovascular disease (CVD). Uremic hyperlipidemia has usually been regarded as one of the most important cardiovascular risk factors (CVRF) in these patients. In order to study whether the "uremia-induced" lipid abnormalities are actually associated with evidence of uremic CVD, and consequently may be considered reliable CVRF, 123 patients on chronic dialysis were reviewed for the presence of CVD and, at the same time, examined for their lipoprotein pattern and other clinical and biochemical variables. Lipids and lipoproteins did not prove helpful in our study in identifying patients with CVD. Despite the fact that they had been on dialysis for a shorter time, CVD patients were significantly older and had higher blood pressure than patients without CVD. Our data suggest that the uremia-induced lipid abnormalities are not reliable markers of CVD in dialysis patients, and support the hypothesis that dialysis per se does not accelerate the atherosclerotic process in uremic patients.
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PMID:Are lipid abnormalities reliable cardiovascular risk factors in dialysis patients? 259 65

The first well-controlled studies of fenofibrate in the United States indicate that the drug is safe and effective for the treatment of type IIa and type IIb hyperlipidemia. Fenofibrate produced a marked reduction in triglyceride (TG) levels (p less than 0.01) as well as a uniform decrease in very-low-density lipoprotein (VLDL) cholesterol levels (p less than 0.01) and a rise in high-density lipoprotein (HDL) cholesterol levels (p less than 0.01) in 227 subjects with both type IIa and IIb hyperlipidemias. Low-density lipoprotein (LDL) cholesterol levels also fell: 20.3% in type IIa and 6% in type IIb subjects. Fenofibrate also affected the structure and composition of some of the major classes of lipoproteins: increases in apolipoproteins (apo) AI and AII and decreases in apo B and apo E were consistent with reductions in TG, VLDL, and LDL and increases in HDL. Tolerance of fenofibrate was excellent, with most side effects being transitory or reversible. Thus, based on the lipid hypothesis of atherosclerosis, therapy with fenofibrate can potentially lead to significant reductions in cardiovascular disease in type IIa and type IIb hyperlipoproteinemia.
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PMID:Review of the effects of fenofibrate on lipoproteins, apoproteins, and bile saturation: US studies. 265 21


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