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

Sufficient evidence from laboratory, epidemiological, and clinical studies indicates that blood cholesterol level is an important risk factor for coronary heart disease and that lowering elevated blood cholesterol levels can reduce that risk. Hyperlipidemia can be successfully treated in most people by use of individualized, progressive, nutritional intervention strategies. Nurses must be appropriately educated in dietary assessment techniques, nutritional education, and patient counseling in order to implement these strategies effectively. Recent advances in nutritional intervention focus on a series of progressive phases for dietary reduction of fat that interact with variables associated with the individual's characteristics and life-style. Nurses in all settings see patients who require intervention to lower elevated blood cholesterol. Important contributions to therapy can be made by nurses in the areas of screening, patient education, promotion of behavioral change, monitoring dietary change and patient outcomes, and integration of nutritional intervention with other therapies. The nutritional intervention aspect of health promotion is integral to nursing practice.
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PMID:Nutritional intervention in hyperlipidemia. 260 56

The role of diet in the prevention and treatment of hyperlipidemia is extremely important. Both elevated cholesterol and diabetes mellitus are risk factors for coronary heart disease, the leading cause of death in adults with diabetes. All health professionals working with diabetic patients must be familiar with the recommendations from the National Cholesterol Education Project and know general dietary guidelines to assist their patients in adopting lower fat eating styles. Dietitians should develop an awareness of the controversial research questions being asked. The role of total fat, cholesterol, saturated fat, monounsaturated fat, polyunsaturated fat, and carbohydrate in the diet will be explored. Implications for practice for dietitians as well as other health professionals will be suggested.
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PMID:Hyperlipidemia and diabetes: the role of dietary fats (continuing education credit). 265 60

This brief review summarizes the evidence linking cholesterol and lipoproteins in blood plasma to the pathogenesis of atherosclerotic disease. The role of specific lipoprotein classes and of modified lipoproteins in the early stages of atherogenesis is emphasized. Clinical trials have provided persuasive evidence of the effectiveness of cholesterol-lowering in modifying the course of coronary heart disease and the progression of atherosclerotic plaques. No conclusions are yet possible, however, about the effect of changes produced in these trials on the concentration of lipoproteins other than low density lipoproteins. Attention is drawn to implications of recent guidelines for cholesterol-lowering for the design of trials of lipid-lowering in hypertensive patients, and to some recent evidence for genetic linkage between hypertension and hyperlipidemia in the pathogenesis of coronary heart disease.
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PMID:Biology of cholesterol, lipoproteins and atherosclerosis. 267 61

Hyperlipidaemia is a major cause of coronary heart disease (CHD) and is especially prevalent in Britain. Prior to lipid-lowering therapy it is necessary to define the type of lipoprotein abnormality present and whether it is primary or secondary. Diet forms the initial treatment but additional drug therapy may be necessary in patients with established CHD or considered to be at high risk of developing CHD or rarely, in the case of severe hypertriglyceridaemia, acute pancreatitis.
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PMID:Current management of hyperlipidaemia. 231 9

Information obtained from clinical and laboratory research strongly supports a causal relationship between hyperlipidemia (dyslipidemia) and coronary heart disease (CHD), and provides an impetus to develop strategy for control of dyslipidemia. Some recent developments in the field may include the use of: (1) colestipol-niacin to control hypercholesterolemia and induce regression of coronary atherosclerosis; (2) limited amounts of foods rich in stearic or oleic fatty acids to enhance the appeal of cholesterol-lowering regimen; (3) gemfibrozil or lovastatin to inhibit cholesterol synthetic activity; and (4) gemfibrozil to raise atherosclerosis-protective plasma high-density lipoprotein levels. These and other newer developments will stimulate interest in research on dyslipidemia and its control to facilitate primary and secondary prevention of CHD.
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PMID:Management of blood lipid abnormalities in coronary heart disease patients. 268 Jan 96

The possible role of medical management of risk factors as an explanation of international trends in coronary heart disease (CHD) mortality has been reviewed. In general, hypertension, hypercholesterolaemia and smoking are the only risk factors that can be detected and treated, with a significant effect on CHD risk. Few organized international data are available to relate to international CHD trends. It appears that the rates of hypertension detection and control are improving, but for many countries, they are still quite low. Less is known about the relative contribution of lifestyle versus medical management as a cause for blood pressure change. Despite these caveats, it appears that blood pressure control may have played a role in CHD mortality trends; further impact of newer antihypertensive agents is likely. The increased medical management of hyperlipidaemia is a relatively recent phenomenon and is unlikely to explain past CHD trends. However, the increased use of these agents and the introduction of more effective agents makes a future effect on CHD likely. The impact of the medical system on smoking cessation is unclear; medical care providers clearly have a major potential role in smoking cessation, but it is difficult to measure. Thus, it appears that medical management of risk factors has had a minor impact on international CHD trends, though the data are sketchy at best. Future research should better delineate the detection and management of risk factors as an increasingly potent source of risk factor change and subsequent reduced CHD mortality.
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PMID:Influences on CHD incidence and case fatality: medical management of risk factors. 268 Oct 21

The Program on the Surgical Control of the Hyperlipidemias (POSCH) is a prospective, randomized, controlled, multi-center, secondary, atherosclerosis intervention trial. POSCH addresses the therapeutic arm of the lipid-atherosclerosis theory, i.e. whether lowering of plasma cholesterol is directly related to a reduction in atherosclerosis risk. In this trial, lipid modification is accomplished by the partial ileal bypass operation. Between 1975 and 1983, 838 patients were randomized into this study. All patients were between 30 and 64 years of age, had survived one and only one electrocardiogram and enzyme-documented myocardial infarction, and had a total plasma cholesterol of at least 220 mg/dl or a low density lipoprotein (LDL)-cholesterol of at least 140 mg/dl if the total plasma cholesterol was between 200 and 219 mg/dl after a minimum of 6 weeks of dietary fat and cholesterol restriction. The primary response variable in POSCH is overall mortality. Secondary endpoints include fatal and non-fatal myocardial infarctions, serial electrocardiographic changes, and, most importantly, sequential coronary arteriography changes. The minimum follow-up is currently planned to be 7 years. Study analyses will be made primarily on the "intention to treat" basis. This paper is the first detailed presentation of POSCH design and methodology. Included are descriptions of study design, implementation, and data collection, including data processing, quality assurance/quality surveillance, and patient safety monitoring. POSCH seeks to demonstrate a significant reduction in overall mortality by lipid modification and to validate the use of coronary arteriographic change as a surrogate endpoint for change in coronary heart disease risk.
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PMID:Program on the Surgical Control of the Hyperlipidemias (POSCH): design and methodology. POSCH Group. 268 77

There is increasing evidence that plasma cholesterol, and particularly low-density lipoprotein cholesterol, has a causal role in atherogenesis. The benefits of cholesterol lowering in terms of reduction of coronary heart disease is well established. This should encourage the identification and treatment of patients with hyperlipidaemia.
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PMID:Medical management of hyperlipidaemia. 268

The relationships between total serum cholesterol levels greater than 200 mg/dl or LDL-cholesterol levels greater than 155 mg/dl (135 mg/dl) and the incidence of coronary heart disease is well established. In contrast an inverse relationship could be shown between HDL-cholesterol levels and the frequency of cardiac death and non fatal myocardial infarction. It also seems to be possible that elevated triglyceride levels (greater than 200 mg) may represent an additional risk factor. Subsequent studies with a large number of patients and longterm observation proved, that fat-modified diets or drug treatment of hyperlipidemia results in a reduction of morbidity and mortality due to coronary heart disease, whereby the reduction of coronary events correlates directly to the degree of reduction of total cholesterol or LDL-cholesterol, respectively. This knowledge allows the clinician to identify persons at high risk for coronary heart disease and to start effective individual therapy in accordance with the recommendations of the European Atherosclerosis Society.
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PMID:[Hyperlipidemia and coronary heart disease]. 269 30

In the past years several studies have confirmed the causal role of the three major risk factors, i.e. hypercholesterolemia, hypertension and cigarette smoking in the determination of atherosclerosis and its major complication, coronary heart disease (CHD). In particular the Lipid Research Clinics Primary Prevention Trial and, more recently, the Helsinki Heart Study, have demonstrated beyond doubt the effectiveness of dietary and pharmacological intervention in subjects affected by hypercholesterolemia. The mounting alertness derived from the results of these and other trials has generated the need for "codifying" strategies directed towards the prevention of CHD in the industrialized western world. The population strategy tends to modify cultural and environmental habits such as diet, cigarette smoking, alcohol abuse, physical exercise etc. The individual strategy is directed at identifying, within each population, those individuals who are probably carriers of a particular risk factor, for instance those affected by hyperlipidemia of genetic origin. The two strategies are intended to be two complementary moments in the ceaseless fight against CHD.
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PMID:[New trends in the prevention of ischemic heart disease]. 270 23


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