of HDL and total cholesterol in the serum of students in adolescence and sex Serumcholesterols und H ufigkeit von Hypercholesterol mie bei Kindern und. Preferred Name. Pseudohomozygous familial hypercholesterolemia. ID. http:// Classified as. Preferred Name. Familial hypercholesterolemia. ID. ontology/MEDDRA/ Classified as. Type IIa hyperlipidaemia. cui.
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Today was a big day at the annual conference of the American Heart Association in Chicago. The lipid hypothesis implies that cholesterol, particularly LDL-cholesterol plays a key role in causing atherosclerosis and coronary heart disease.
The association hypercholsst cholesterol and overall bypercholest appears more complicated. However, the mortality curve appears J-shaped which means that those with the lowest cholesterol levels have increased mortality. In other words, there may be underlying reasons for high and low cholesterol. Drug trials where half of the patients are treated with a certain drug and half are treated with placebo are a typical example of controlled intervention trials. In fact, the validity of the lipid hypdrcholest has been tested in controlled interventional trials.
LDL-C was significantly lowered in the intervention group compared to the comparison group. Nonetheless, after six years of follow-up, there were no differences between the groups in the incidence of coronary heart disease and stroke. However, during a follow-up of seven years, there was no significant difference in total death rates between the groups and no differences in the number ro, deaths from heart disease.
Most experts agree that the use of statins has revolutionized the treatment of coronary heart disease.
Double-blind placebo-controlled trials have shown that statins reduce mortality and lower the risk of future cardiovascular events. If the lipid hypothesis is correct, most of the efficacy of statins is due to their cholesterol-lowering effects. Statins are potent inhibitors of cholesterol biosynthesis. Ezetimibe blocks the absorption of cholesterol from the small intestine. It was designed to evaluate the effects of concomitant simvastatin and ezetimibe ril compared to simvastatin therapy alone on the composite endpoint of cardiovascular death, nonfatal myocardial infarction, rehospitalization for nie angina, coronary revascularization, or stroke.
The average age of the patients was 64, and about a fourth were women. Patients were followed for an average of six years. Primary endpoint events occurred in This represents a 6. Interestingly 49 out of 50 patients treated saw no benefit. No safety issues were found, and there were no differences between the groups in cancer, muscle or gall-bladder related events. I wonder if the results would have been larger or smaller were that not the case.
I think a secondary analysis, addressing the results of only the patients who stayed on the study drug, is scheduled for presentation at the AHA meeting tomorrow.
It is surprisingly large, indeed. However, it seems there was no significant difference between the control and the treatment arm in this sense?
Wondering if I should take the Lipitor my doc wants me to take. No other risk factors other than genetics. Will be able to send all numbers when I return home to view. My dad takes a statin. Your cholesterol markers are bad due to your diet; Too many carbs and not enough fat. Grains are especially problematic.
Grains turn to sugar, and your numbers show you are eating too many. The side effects of statins are awful, not to mention they have been known to cause heart disease. Please go to FB and check out a few pages by reputable docs: Stephen Sinatra, and Dr. Have either you or I missed something? The study authors write the following:. As delivered, the dietary intervention was not expected to hyprcholest substantial effects on lipoprotein levels, but it is possible that a diet specifically lower in saturated and trans fat combined with increased intakes of vegetables ,fruits, and grains might have led to a decrease in CVD risk.
If anything there was a slight trend towards a lower risk of diabetes in the control group. Low-density lipoprotein cholesterol levels, diastolic blood pressure, and factor VIIc levels were significantly reduced by 3.
This is at least how I understand it. BMI, blood-pressure, alcohol intake, possible even glucose hyeprcholest. I think this is an important issue to point out. Old people with cancer and other chronic disease often looses radically weight at the last years. While predisposing to death they have low blood-pressure and very low BMI.
The Hypercoagulable State in Hypercholesterolemia
However, we should be able to differentiate between snap-shots of time and life-time exposure. A recent study showed that mechanically removing LDL cholesterol from the blood reduces arterial inflammation in FH patients https: There was no difference between the groups in overall death rate, or death rate from cardiovascular disease. There were significant reductions in the rate of myocardial infarction, stroke, and ischemic stroke in the treatment group, and.
Mark I assume the reductions in MI and stroke were reductions in non-fatal events. We therefore have to assume that mortality from non-cardiovascular causes was similar as well. Besides, some of the participants were already on cholesterol-lowering diets, unlike e. But it supports the lipid hypothesis, and the results from PSCK9-inhibitor studies may bolster it further.
So, the survival of the lipid hypothesis will continue to be the lifeblood of the pharmaceutical industry for years to come.
The Lipid Hypothesis – Closing in on the Truth
Are there any studies underway on PCSK-9 alone? I have only seen those in combination with statins. Seems like that would put the controversy to rest once and for all.
Elliot All the ongoing trials on people with known cardiovascular disease are with PCSK9-inhibitors added to statin therapy. There are probably some ongoing studies on PCSK9 inhibitors alone in other populations. For example it has been suggested that PCSK9 inhibitors may be useful in jypercholest who are statin intolerant.
Modest changes in diet will yield modest changes in lipid profile. The mean age at the randomization in statin trials is hypercholsst and the mean duration few years.
I think the same goes for diet trials. Within this narrow window at later stages of life, a large reduction in LDL is needed for meaningful results. Given a population with life-long exposure to high SFA diet, a much broader time period is needed. However, if we start early, even modest difference in LDL should prove to be beneficial.
This is the hjpercholest conclusion one can draw from the genetic data. I do not agree with your comment: A familiy physician in Iceland with a history of CVD and metabolic syndrome published an article in hpercholest of the newspapers where he described his experience with LCHF.
The table above shows his labresults before and after. The column on the left is from the 10th of June, just when he started. The column on the right is 2 dol later! He has done several measurements since then that have shown that his lipid profile had stabilized at this level. He is far from being the only example of this, in my practice I have seen quite a few other patients getting similar results.
This article was published in JAMA that describes this carbohydrate-sensitive hyperglyceridemia:. Of course I too have seen people influence their LDL cholesterol levels through diet. I was merely referring to the clinical mmie where it has turned out be difficult to get a meaningful lowering of LDL cholesterol through lifestyle or dietary measures, at least if you compare it to the effect of statins.
On the other hand we should keep in mind that risk hypedcholest be influenced without lowering LDL-cholesterol. Remember the LYON-Heart study were men with coronary artery disease who were randomized to a Mediterranean diet fared better than those randomized to the prudent low fat diet. However, LDL-cholesterol stayed the same in both groups. Regarding the Lyon study — according to the paper, high cholesterol and blood pressure were indeed significant predictors of events. The low LDL levels in these patients at baseline seem to suggest that coronary cases already have lower LDL than the healthy population of the mue age.
Perhaps reverse causation — their LDL levels was low because of the disease. If you mue drunk and crash your car, you are more likely to die going k than going 90k.
This sort of confusion is why hypegcholest use the criteria defined by Bradford Hill back in the 60s.
These were the two main inclusion criteria: Axel I am not good at maths…. The anti-inflammatory and Nitric oxide effects of Statins has been known for many years. Perhaps their general population are not capable. There are only 2 other Countries that use this method….
Liberia and Myanmar Burma. Other endpoints including MI The erratum was on my mental syllogisms. I was thinking that to give rise to a meager overall 6. Curious how everyone of them is higher than computed from the absolute risk numbers though.
In the MI case if we take the numbers of absolute risk with one more digit favoring a higher relative risk reduction so How this trial can be seen as a success is beyond me. I can hjpercholest now how it is going to be used for selling ezetimibe to anyone in secondary prevention irrespective of their LDL number.