Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate the effect of various antihypertensive drugs on fasting and postprandial lipids and lipoproteins, we studied 39 normolipidemic hypertensive patients, 28 men and 11 women aged 52.3 +/- 9.0 and 58.5 +/- 7 years, respectively. After four weeks of placebo administration, lipids and lipoproteins were measured in the fasting state and every three hours for a period of nine hours after intake of a standardized fat mixed load (65 g/m2). Following this test, the patients were randomly assigned to one of four treatment groups: group I metoprolol (n = 10), 100 mg/day; group II nicardipine (n = 9), 90 mg/day; group III captopril (n = 11), 75 mg/day. At the end of week four of treatment the fasting and postprandial lipid measurements were repeated. Blood pressure mean values were significantly (p < 0.05) reduced in the four treatment groups. We found no statistically significant lipids or lipoproteins changes neither in the fasting nor in the postprandial state, but a trend toward lower concentrations in the postprandial lipemia after treatment was observed in three groups (metoprolol, nicardipine and captopril), whereas no change was observed in the chlorthalidone group. These data confirm that fasting lipids and lipoproteins in normolipidemic hypertensive patients are not unfavorably changed by low doses of the drugs studied. In addition, we inform that postprandial lipemia is not affected by these four drugs in the doses used.
Arch Inst Cardiol Mex
PMID:[Fasting and postprandial lipids and lipoproteins during the chronic administration of antihypertensive drugs]. 784 Jul 30

We evaluated in a double-blind, placebo-controlled, randomized trial of 45 well-defined patients with familial combined hyperlipidemia, the effect of gemfibrozil (1,200 mg/day) or simvastatin (20 mg/day) on apolipoprotein-B (apo-B)-containing lipoproteins, low-density lipoprotein (LDL) subfraction profile, and LDL oxidizability. Although both drugs reduced plasma cholesterol and triglyceride concentrations, gemfibrozil reduced plasma triglycerides more effectively and simvastatin reduced plasma cholesterol more effectively. LDL cholesterol was reduced with simvastatin. With both drugs, total serum apo-B concentration decreased. With gemfibrozil, this was due to an exclusive reduction (-46%) of very low/intermediate-density lipoprotein (VLDL + IDL) apo-B, whereas simvastatin decreased apo-B in both VLDL + IDL and LDL (34% and 15%, respectively). Initially, a dense LDL subfraction profile was present in all patients. The decrease in LDL cholesterol with simvastatin was due to a decrease in all isolated LDL subfractions except LDL2; gemfibrozil increased LDL1 and LDL2 cholesterol (p = 0.001) and reduced LDL4 cholesterol, resulting in a more buoyant LDL subfraction profile compared with simvastatin. In both groups, a predominance of small dense LDL remained despite therapy. LDL fatty acid composition showed a shift from oleic acid to linoleic acid after gemfibrozil; arachidonic acid increased after simvastatin. Vitamin E was lower after gemfibrozil. In the measurements of LDL oxidation, only the oxidation rate was significantly reduced with simvastatin. Thus, quantitative and qualitative changes of LDL cholesterol had only a small effect on total in vitro LDL oxidizability in this population with familial combined hyperlipidemia.
Am J Cardiol 1995 Feb 15
PMID:Comparison of gemfibrozil versus simvastatin in familial combined hyperlipidemia and effects on apolipoprotein-B-containing lipoproteins, low-density lipoprotein subfraction profile, and low-density lipoprotein oxidizability. 785 26

A common, genetically influenced lipoprotein subclass profile characterized by a predominance of small, dense low density lipoprotein (LDL) particles is associated with relative increases in plasma triglyceride and apolipoprotein (apo) B-100, and reduced levels of high density lipoprotein cholesterol and apoAI. Recently, this phenotype has also been associated with the insulin resistance syndrome and familial combined hyperlipidemia. Case-control studies of patients with myocardial infarction and angiographically documented coronary artery disease (CAD) have demonstrated that 40-50% of patients have the small, dense LDL phenotype and that this is associated with a 2- to 3-fold increase in disease risk. However, because of strong statistical correlations among the multiple features of the phenotype, it has been difficult to determine whether > or = 1 of its metabolic alterations are primarily responsible for increased CAD susceptibility. More direct evidence for enhanced atherogenicity of lipoproteins in this trait derives from a recent report that LDL-cholesterol lowering by diet and drug treatment resulted in reduced coronary angiographic progression in CAD subjects with predominantly dense LDL, but that an equivalent lowering of LDL cholesterol in subjects with more buoyant LDL was not associated with angiographic benefit. Further, in vitro findings have indicated increased susceptibility of small, dense LDL to oxidative modification and relatively greater binding of these particles to arterial wall proteoglycans. Thus, the small, dense LDL trait may underlie familial predisposition to CAD in a large proportion of the population, and its presence may indicate the potential for benefit from specific therapeutic interventions.
Am J Cardiol 1995 Feb 23
PMID:Dense low density lipoproteins and coronary artery disease. 786 75

Pathologic studies have shown that atherosclerosis may already be present in childhood as reversible fatty streaks in the aortic intima. These findings are directly related to total serum cholesterol and inversely related to serum HDL cholesterol. This study was aimed at screening children and young adolescents of Novara for cardiovascular risk factors and achieving a specific health educational program. We screened a sample of 2560 children and young adolescents aged 10 to 16 years (mean 12) for known family history of cardiovascular diseases and hyperlipidemia, blood pressure values, serum cholesterol fractions and triglycerides. Of the 2560 children, 786 were considered at risk according to pre-defined cutoff points for systolic BP (> 120 mmHg) 10.6%, diastolic BP (> 80 mmHg) 3.4%, total serum cholesterol (= > 160 mg/dl) 18.7%, serum HDL cholesterol (< 40 mg/dl) 49.5%, total serum cholesterol/HDL ratio (> 4) 28.0%, and triglycerides (> 150 mg/dl) 3.7%. Parents were invited to change family lifestyle according to a specific health educational program, which included advice about diet and physical activity. All children at risk were re-examined 1 year later. Mean values of total serum cholesterol (129 +/- 26 vs 143 +/- 30, p < 0.001), triglycerides (86 +/- 28 vs 91 +/- 32, p < 0.01) and total serum cholesterol/HDL ratio (3.7 vs 3.8, p NS) were found to be lower than at index evaluation. The distribution of total cholesterol curve shifted to the left, and the high risk cases (total serum cholesterol > 200 mg/dl) lowered from 56 to 24 at the follow-up evaluation.(ABSTRACT TRUNCATED AT 250 WORDS)
G Ital Cardiol 1994 Feb
PMID:[Experience in primary prevention of cardiovascular risk factors in children]. 801 73

Cerebrovascular accidents (CVAs) are the third commonest cause of death in France. Approximately 15% of them are due to stenosis of the extracranial internal carotid. The fact that a third of CVAs are followed by death and another third by major handicaps leads to the need for careful prevention. This has three aspects: 1) Correction of risk factors: hypertension, smoking, hyperglycemia, hyperlipidemia, obesity, alcohol abuse, hematological abnormalities and oral contraception; 2) the prescription of one of two platelet anti-aggregants, the efficacy of which has been proved: acetylsalicylic acid or ticlopidine; 3) surgical elimination of tight carotid stenoses. The following require surgery: 1) more than 70% stenosis following cerebral or ocular TIA or minor CVA; 2) more than 75% stenosis in asymptomatic patients or with episodes of VBI as well as 70% in case of thrombosis of the contralateral internal carotid; 3) following a CVA leaving serious sequelae: tight stenosis when it is reasonable to assume that a further CVA could lead to clinical worsening or to a loss of independence; 4) symptomatic and/or more than 80% restenosis. The decision should be made only after confirmation of the diagnosis and of the degree of stenosis and verification of the absence of any local or systemic contra-indication. The surgical team must have a low cumulative mortality and perioperative CVA rate. These patients require ongoing medical monitoring, particularly from a cardiological standpoint.
Ann Cardiol Angeiol (Paris) 1994 May
PMID:[Treatment of patients with atherosclerotic carotid stenosis in 1993. Indications and long-term results of surgery]. 807 24

Vein graft atherosclerosis is a common and serious complication of coronary artery bypass grafting (CABG). There is mounting evidence that lipoprotein abnormalities play an equally important role in the development of lesions in saphenous vein grafts after CABG as in native coronary vessel disease. The potential benefit of low-dose lipid lowering combination therapy in these patients has not been investigated. In a randomized, double-blind, placebo-controlled study, we compared the efficacy and safety of a low-dose combination of colestipol 10 g and simvastatin 10 mg/day (CS) to colestipol 10 mg and bezafibrate 400 mg/day (CB) for 2 months in 33 patients with serum total cholesterol > 6.5 mmol/l and triglyceride < 4.5 mmol/l who had undergone CABG for severe coronary artery disease. In the CS group, total cholesterol decreased by 29% and low-density lipoprotein (LDL) cholesterol by 42%; similarly, CB reduced total cholesterol by 17%, LDL cholesterol by 23%, triglyceride by 19%, and increased high-density lipoprotein (HDL) cholesterol by 14%. Lipoprotein (a) and hemostatic factors were unaffected by either therapy in this study. Both combination therapies were well tolerated with no significant clinical or biochemical side effects. We conclude that low-dose combinations of colestipol and simvastatin or colestipol and bezafibrate are effective and well tolerated in the management of moderate hyperlipidemia in patients who had undergone CABG.
Clin Cardiol 1994 Feb
PMID:A randomized pilot trial of low-dose combination lipid-lowering therapy following coronary artery bypass grafting. 816 27

The purpose of this study was to investigate the efficacy of the patient-based coronary heart disease (CHD) risk management strategy in general practice by analyzing patients who were sent to a specialized center as refractory to conventional treatment. Of the 452 patients studied, 152 were excluded because of secondary hyperlipidemia. The effects of a food protocol-monitored dietary/drug treatment on lipid profiles and CHD risk indices and the compliance to this approach were monitored for 12 months in 300 of 452 patients. CHD risk classification was performed according to NIH criteria by the referring physicians, but secondary hyperlipidemia was not identified and treated appropriately. Physicians did not fully utilize dietary and drug treatment and referred the patients to a specialized center too early. The initiated food protocol-controlled treatment was more efficient than pretreatment in general practice, with a compliance of 80.3% by patients selected according to their CHD risk. Long-term CHD risk reduction was persistent for 12 months in compliant patients; however, a cumulative dropout rate of 43% after 6 months and of 68% after 12 months was noted. Statistical analysis failed to reveal consistent prognostic factors of long-term compliance.
Clin Cardiol 1994 Mar
PMID:Effectiveness of coronary heart disease risk management in high-risk patients. 816 80

We have developed a targeted approach to identification of high-risk patients in British Columbia, Canada, as an initial strategy for the prevention of coronary disease. Patients with the diagnosis of familial hypercholesterolemia have been identified through the Lipid Clinic. First degree relatives of these persons and subsequently identified individuals will be screened for the presence of hypercholesterolemia. Using this approach, the likelihood of identifying persons at high risk is high, close to 50%. The program will also allow collection of data on factors affecting the expression of hyperlipidemia and atherosclerosis and their response to therapy. In an effort to establish the infrastructure that would be necessary for identification and management of such patients throughout the province, a Lipid Clinic Outreach Program has been developed. The objective is to provide each community in the province with expertise to manage hyperlipidemia without traveling to a major urban area. With this infrastructure in place, this will serve patients who have premature atherosclerosis due to other causes and will also form the framework for dissemination of heart health policies and programs by different levels of government, voluntary and professional organizations, as well as the private sector. From a targeted family centered pilot program, a broad approach to the prevention of coronary artery disease in this community will be possible.
Am J Cardiol 1993 Sep 30
PMID:Development of a program for identification of patients with familial hypercholesterolemia in British Columbia: a model for prevention of coronary disease. 821 93

Heterozygous familial hypercholesterolemia (FH) is completely expressed at birth and early in childhood by significant elevations in plasma total and low density lipoprotein (LDL) cholesterol levels. High density lipoprotein cholesterol can be low in such FH children; the triglyceride levels are usually within the normal range. Screening of children for heterozygous FH using a LDL cholesterol level is reasonably efficient in families with known FH, but for general population screening, the LDL cholesterol level is often too nonspecific. Screening of offspring with a positive family history of premature coronary artery disease will provide a panoply of different lipoprotein phenotypes, reflecting the presence of other genetic conditions, including familial combined hyperlipidemia. Guidelines have been developed by the National Cholesterol Education Program (NCEP) Expert Panel on Blood Cholesterol levels in Children and Adolescents to assist in the evaluation and treatment of children with high LDL cholesterol levels. Although heterozygous FH probably counts for < or = 5% of premature coronary artery disease, its identification and treatment are important, because FH often causes marked premature coronary artery disease early in adulthood, and can be successfully treated with a combined dietary and drug approach.
Am J Cardiol 1993 Sep 30
PMID:Identification and treatment of heterozygous familial hypercholesterolemia in children and adolescents. 821 94

This paper is about the effort to measure the assistance load at the first level of attention given by arterial hypertension and care risk factors. It is been worked as a demonstration project to initiate activities within the setting of a Health Center. The risk factors are explored from the proportions of patients with the problems of obesity, smoking, hyperlipidemia, diabetes mellitus and alcoholism. The information was obtained from 395 consecutive cases out of 1100 persons who came to the center in a month period. They were 325 women (82.2%) and 70 men (17.2%) with a range of 18 to 85 years, average 40 +/- 17 and a median of 36. Obesity was encountered in 35.7% in men and 48.8% in women. Diabetes was found in 9.1% both sexes. Hypercholesterolemia > 200 mg/dl in 30.4% and > 240 mg/dl in 19.6%. Alcohol abuse was encountered in 14%, 9.2% in women and 37.7% in men. Smoking was present in 22.3% of them, 16.3% in women and 50% in men. High blood pressure > 140/90 mm Hg or hypertension history was present in 21% of the cases. Controlled cases were 6.6%. In the whole group 34% showed at least one risk factor, 57% showed two factors and 66% showed three factors. Therefore, the best estimate of assistance load, on the fight of risk factors associated to hypertension should not consider less than 70% among the regular subjects coming to this health center.
Arch Inst Cardiol Mex
PMID:[Arterial hypertension and other coronary risk factors in primary care]. 829 29


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