Controlling plasma cholesterol is one of the major ways to reduce the risk of developing cardiovascular diseases (CVD). Total body cholesterol includes different components such as low-density lipoprotein (LDL) and triglyceride (TG), the “bad cholesterols”, and high-density lipoprotein (HDL) or “good cholesterol”. The Adult Treatment Panel III (ATP III) guideline recommends monotherapy with statins as the primary drug therapy for dyslipidemia by lowering LDL cholesterol. However, statins do not prevent all cardiovascular (CV) events and residual risk remains. Fenofibrates, by decreasing the level of TG and increasing HDL are considered adjunctive therapy in reducing the risk of CVD.1 Several studies investigated the benefits of adding fenofibrates to statins in increasing HDL level and thus decreasing CV events. HD Shah, KH Parikh, MC Chag, et al, compared the benefit of combination therapy of statin and fenofibrate versus monotherpay with statins. In this randomized, non-blinded, prospective study 102 patients with Acute Coronary Syndrome (ACS) who previously had angioplasty were randomly assigned to one of four groups: atrovastatin 20mg daily (n=25); simvastatin 40mg (n=27); atrovastatin/fenofibrate combination 10mg/day-200mg/day respectively (n=25) or simvastatin/fenofibrate 20mg/day-200mg/day respectively (n=25). The serum lipid and plasma fibrinogen were measured at baseline and then tree months following therapy. The study showed that combination therapy with fenofibrates further reduced the TG and LDL levels, increased HDL and significantly decreased plasma fibrinogen. 2 The Veteran Affairs HDL Intervention Trial (VA-HIT) investigated the effect of the fenofibrates derivative, gemfibrozil, on the occurrence of majo... ... middle of paper ... ...k of CVD. Works Cited 1. Grundy SM, Gleeman JI, Mertz CN et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004;110:227-39 2. HD Shah, KH Parikh, MC Chag, et al. Beneficial effects of the addition of fenofibrate to statin therapy in patients with acute coronary syndrome after percutaneous coronary interventions: Exp Clin Cardiol 2007;12(2):91-96) 3. Sander J. Robins; Dorothea Collins; Janet T. Wittes; et al. Relation of Gemfibrozil Treatment and Lipid Levels With Major Coronary Events: VA-HIT: A Randomized Controlled Trial, JAMA. 2001;285(12):1585-1591 (doi:10.1001/jama.285.12.1585) 4. The ACCORD Study Group, Buse JB, Bigger JT, Byington RP. Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus; NEJM oa 1001282. published at www.nejm.org March 14, 2010)
(15)Patel M, Mahaffey K, Garg J, Pan G, Singer D, Hacke W, Breithardt G, Halperin J, Hankey G, Piccini J, Becker R, Nessel C, Paolini J, Berkowitz S, Fox K.. (2011). Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.. New England Journal Of Medicine. 365 (10), 883-91.
Almost everybody knows the negative effects bad cholesterol has on the body. Bad cholesterol has to do with low-density lipoprotein’s molecular transport deposits that thicken in the walls of the arteries hindering the flawless passage of blood affecting the atherogenic status of the arterial walls. But not everybody fully appreciates the important role cholesterol plays in the body. This non-soluble, waxy substance is essential to aid in the building of membranes, the manufacture of bile, strengthening of cell walls and nerve sheaths, and in the production of hormones.
Hypercholesterolemia is the presence of high levels of cholesterol in the blood. Cholesterol is a waxy fat-like substance and is a major class of lipid, so it gets into the blood by lipoproteins [1]. A high level of lipoproteins is unhealthy. A high level can result in an elevated risk of atherosclerosis and coronary heart disease [2]. The high levels of lipoproteins are often influenced by a combination of genetic and environmental factors such as obesity or dieting habits [2]. High cholesterol can be caused by mutations in the following genes: APOB, LDLR, LDLRAP1, and PCSK9 [3]. Mutations in the LDLR gene are responsible for causing familial hypercholesterolemia, which is the most commonly seen form of inherited high cholesterol [3]. The LDLR gene contains instructions for making LDL receptors or low-density lipoprotein receptors. LDL receptors play critical roles in regulating levels of cholesterol in the blood by removing low-density lipoproteins from the bloodstream. Mutations in the LDLR gene can make the amount of LDL receptors produced less than normal or affect their job of removing the low-density lipoproteins in the blood [4]. People who have these mutations will have higher levels of cholesterol. There are many ways that the environment can affect the levels of cholesterol in the blood. Reducing the amount of dietary fat you consume lowers the total amount of cholesterol in the blood [5]. Sucrose and fructose can raise the amount of LDL in the blood. Reducing fatty foods will however lower the amount of LDL [5]. Having a healthy body and maintaining physical exercise plays a key role in keeping your cholesterol at a healthy level. If you are overweight or obese you can lower your cholesterol levels by simply losing ...
CAD is a leading cause of morbidity and mortality throughout the worldwide. The prevalence of biological and metabolic risk factors were also found to be high in development of coronary artery disease. Patients with hypercholesterolemia are at increased risk to experience cardiovascular events and to die from vascular disease [2]. .Statins, among the most commonly prescribed drugs worldwide, are cholesterol let downing agents used to manage cardiovascular and coronary heart diseases and to treat hypercholesterolemia. Statin’s therapy ...
Sethi, J. K., Vidal-Puig, A. J., (2007). Targeting fat to prevent diabetes. Cell Metab. . 5 (5), 357-70.
There are almost 7 million Americans in the United States that suffer from Coronary Artery Disease today. The prognosis for many of these patients depends upon the major therapeutic option of medical management that they choose to receive, the most essential variables that predict the prognosis and likelihood for future events are the extent and severity of the disease at the time of diagnosis. Basically, this translates to mean that the more abnormal the scans and tests are, the higher the prognosis is going to be for future coronary events to occur and therefore the higher the prognosis is going to be for a shorter life span, the lower the progression of the disease the higher the chance is going to be for a longer life span for the patient. A higher risk patient is going to be one with extensive defects from the disease, a patient with little to no defects is going to be low risk, and those with limited defects are going to be at a more intermediate risk. Whether it is because of their familial history of the disease or because of risk factors such as smoking, high blood pressure, high cholesterol, or obesity really does not matter considerably because many of the 500,000 deaths that occur from this disease could be prevented if more of the risk factors were prevented. This disease is the number one killer of both men and women older than 65 years of age because coronary artery disease in contracted as a result from the narrowing of the coronary arteries that feed the heart, and when those arteries become clogged and cannot supply enough blood, oxygen and nutrients in the coronary arteries, people develop chest pains, also more commonly known as angina which is a secondary condition of having Coronary Artery Disease. . These t...
It can be prevented naturally by practicing vegetarianism which refers to those who practice a diet low in meat and fish or may not consume meat products at all. Vegetarianism diet offers an advantage because people who practice or change their lifestyle to no meat consumption have lower body mass index (BMI), and can reverse the effects of atherosclerosis. (reducing, 2010). However, people have to be careful while practicing it because a poorly vegetarian diet can cause anemia, fatigue, decreased zinc, decreased vitamin C. Also it can decrease B12 and this may cause neural tube defects, congenital heart defects, dementia, and Alzheimer’s disease. It is very important to educate vegetarians to have a vitamin B supplementation to prevent another type of conditions. (reducing, 2010). There is another way to prevent or reverse heart disease by consuming seven heart nutrients which are fiber, fish oil, magnesium, vitamin D, vitamin K, zinc, and COQ10. Also, there are statin drugs such as Crestor (rosuvastatin) and Lipitor (atorvastatin) that are being prescribe to cholesterol-lowering but there is a concern about their safety and effectiveness. There is an alternative to these types of drugs. The statin alternatives are Niacin (B3) known to be effective in lowering blood cholesterol and triglyceride levels, and citrus flavones that work blocking the enzymes in the liver
The American Medical Women's Association. Guide to Cardiovascular Health, New York, NY: Dell Publishing, 2009.
Answer: The evaluated group of 500 patients within this study is considered to be a sample. The 500 patients whom possess high cholesterol are comprised of the larger group of patients of which serve holistically as the population. The 500 patients randomly selected from the total population with high cholesterol of which 67% were found with heart disease constitute as the sample.
O'Brien, D. (2009). Randomized controlled trials (RCTs). In R. Mullner (Ed.), Encyclopedia of health services research. (pp. 1017-1021). Thousand Oaks, CA: SAGE Publications, Inc. doi: http://dx.doi.org.proxy1.ncu.edu/10.4135/9781412971942
Myocardial infarction and acute coronary syndrome require the same medications such as: “aspirin, nitroglycerin, morphine, beta blockers, and thrombolytics” (Smeltzer, pp. 744, 2010) Oxygen administration and a 12-lead electrocardiogram is also required upon arrival to the hospital. A PCIS is a procedure for “opening the occluded artery and providing perfusion to the area of the heart that has been deprived of oxygen” and should be done in less than one hour of patient arrival (Smeltzer, pp. 745, 2010). When a PCI is contraindicated or unavailable at a certain facility, thrombolytics are admistered to “dissolve the thrombus in a coronary artery” in order for reperfusion to the deoxygenated area of the heart to occur (Smeltzer, pp. 745, 2010). After the initial medical treatment for acute coronary syndrome and a myocardial infarction, “continuous cardiac monitoring” is required to ensure that another episode is not going to occur (Smeltzer, 745, 2010). Monitoring is preferably done on an intensive care unit because of the severity of the complications that could occur. Medications such as “aspirin, beta-blockers, and an ACE inhibitor” is included in the ongoing treatment (Smeltzer, pp. 745, 2010). Cardiac rehabilitation is initiated after the patient with acute coronary
Turner, B. J., Newschaffer, C. J., Zhang, D., Fanning, T., & Hauck, W. W. (1999). Translating clinical trial results into practice. Annals of Internal Medicine, 130(12), 979-986.
Moll, J. (2008, October 06). Can The Mediterranean Diet Lower Cholesterol. Retrieved December 1, 2013, from About: http://cholesterol.about.com/od/cholesteroldiets/a/mediterranean.htm
My DRI of cholesterol was maxed at 300mg and my intake was 267mg. Still relatively high so could start consuming Oatmeal for breakfast in which reduces your low-density lipoprotein (LDL), the "bad" cholesterol. Also, I...
The tendency to build up high cholesterol may run in families, but extremely high levels are usually the result of a poor diet high in saturated fats and calories, along with little or no exercise. In some cases, high levels of cholesterol may be associated with undiagnosed medical symptoms such as diabetes or low thyroid function. According to the American Heart Association, there would eventually be a 50 percent lower rate of heart disease if Americans would lower their blood cholesterol levels by 25 percent. These statements find confirmation in a 1984 report done by the National Heart, Lung and Blood Institution on the results of a 10 year study. It showed that for every 1 percent of lowered cholesterol, the chances of a heart attack are lowered by 2 percent.