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

Hyperlipidemia is common in patients with the nephrotic syndrome. The main cause is probably increased hepatic lipogenesis, a non-specific reaction to falling oncotic pressure secondary to hypoalbuminemia. Cardiovascular morbidity and mortality are increased in patients with the nephrotic syndrome, with the exception of patients with minimal change disease. It is not clear whether this is caused by the hypercholesterolemia or secondary to uremia or medical treatment. Experiments suggest that hypercholesterolemia may cause glomerulosclerosis, a common complication of the nephrotic syndrome. The hypercholesterolemia of the nephrotic syndrome can now be treated effectively with HMG coenzyme A reductase inhibitors.
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PMID:[Hyperlipidemia in nephrotic syndrome]. 194 40

Cardiovascular morbidity and mortality are increased 4- to 6-fold in patients with type II diabetes. The high prevalence is multifactorial and reflects in part the adverse influence of covariate, cardiac risk factors such as hypertension and hyperlipidemia. Type II diabetes is characterized by insulin resistance, hyperinsulinemia, and altered carbohydrate and lipid metabolism resulting in hyperglycemia, increased concentrations in blood of very low-density and low-density lipoproteins, and decreased blood high-density lipoproteins. Abnormalities seen predispose to vasculopathy through lipid deposition into vessel walls associated with monocyte infiltration, vascular smooth muscle cell proliferation, arterial mural fibrosis, and thrombosis. Conventional therapy for cardiovascular disease such as angioplasty and bypass surgery are of only limited efficacy. Thus, retardation of progression of atherosclerosis is essential. In addition to focusing on co-existent cardiac risk factors such as hypertension, therapy for patients with type II diabetes should reduce or reverse insulin resistance, improve metabolic control, and, ideally, do so without exacerbating hyperinsulinemia. Diet and exercise are central, and novel orally active hyperglycemic agents such as the biguanides and the thiazolidinediones that sensitize diverse tissues to insulin offer particular promise.
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PMID:Determinants of coronary vascular disease in patients with type II diabetes mellitus and their therapeutic implications. 913 73

Cardiovascular morbidity, including coronary artery disease and left ventricular hypertrophy, and mortality are high in patients following renal transplantation. Cardiovascular disease is thought to be due to traditional (hypertension, hyperlipidemia, diabetes mellitus and smoking) as well as nontraditional cardiovascular risk factors (microinflammation). Furthermore, immunosuppressive drugs, namely, calcineurin inhibitors, sirolimus, and steroids, have been reported to adversely affect cardiovascular risk factors (e.g., hypertension, hyperlipidemia, hyperglycemia). Evidence from comparative trials and from conversion studies suggest that blood pressure, hyperlipidemia, and hyperglycemia after renal transplantation may be differentially affected by the calcineurin inhibitors cyclosporine and tacrolimus. In the European Tacrolimus versus Cyclosporin A Microemulsion Renal Transplantation Study, 557 patients were randomly allocated to therapy with tacrolimus (n = 286) versus cyclosporine (n = 271). In addition, to blood pressure, serum cholesterol, HDL cholesterol, triglycerides, and blood glucose, we estimated the 10-year risk of coronary heart disease (Framingham risk score). Tacrolimus resulted in a significantly lower time-weighted average of serum cholesterol (P < .001), and mean arterial blood pressure (P < .05), but a higher time-weighted average of blood glucose (P < .01) than cyclosporine. Mean 10-year coronary artery disease risk estimate was significantly lower in men treated with tacrolimus, (10.0% versus 13.2%; P < .01) but was unchanged in women (4.7% versus 7.0%). Tacrolimus and cyclosporine microemulsion have compound-specific effects on cardiovascular risk factors that differentially affect the predicted rate of coronary artery disease.
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PMID:Cardiovascular risk estimates and risk factors in renal transplant recipients. 1591 88