Atherosclerosis is the culprit behind coronary heart disease (CHD) and stroke, which is the most common cause of death worldwide and in the United States10. Among the modifiable risk factors of CHD and stroke is the serum low density lipoprotein level (LDL)8, 11. Several randomized clinical trials have established that reducing the serum LDL level results in a reduction in the future risk of CHD and stroke in a linear relationship, in one study it was estimated that reducing the LDL by 1 % would reduce the risk by 1.7 %.1-4, 7, 9, 13 Lipid altering drugs include several classes of medications each of which have their own mechanism of action. Statins inhibit HMG CoA reductase (hydroxymethylglutaryl CoA reductase), which is the rate-limiting enzyme for the production of cholesterol in the liver. Statins competitively inhibit this enzyme and induce an increased expression of LDL receptors in the liver. Which in turn increases the uptake catabolism of serum LDL into the liver resulting in decreased serum cholesterol level. This reduction in serum LDL and cholesterol levels has resulted in reduction of 10-year CHD and stroke risk. Pitavastatin was approved in Japan since 2003 and was granted FDA approval in 2009 and is marketed under the name of Livalo. Several phase III and IV trials have shown that Pitavastatin is both safe and efficacious in lowering both serum LDL and Triglycerides (TG) by 29.1% and 22.7% respectively from baseline levels which was significant. These studies showed that only 10% of Pitavastatin treated patients had adverse events (AE) in which 84% of these events were mild and about 1% were serious adverse events (SAE)6, 12, 14, 16-26, 28-31. Atorvastatin is the most commonly used statin in clinical practice; the F... ... middle of paper ... ...iovascular and cerebrovascular events and related deaths, which this study is going to test. 3.3 DESCRIPTION OF YOUR PRIMARY OUTCOME MEASURE The primary outcome measure that is chosen for our study is the serum LDL level change from baseline. We believe it will serve as an objective measure of our intervention and comparator effects. 3.4 DISCUSSION OF IMPLICATIONS Up to our knowledge, there are no randomized clinical trials that compared Pitavastatin with Atorvastatin with the same endpoints that we set for this trial. We believe that establishing a clinical evidence to support the use of Pitavastatin as an alternative to the most commonly used statin in a clinical setting is of great importance. Moreover, there is no evidence that Pitavastatin can reduce both cardiovascular and cerebrovascular events and related deaths, which this study is going to test.
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 ...
Drug therapy: The patient will discontinue the use of Lipitor and the patient will now be on Rosuvastatin (Crestor) 80 mg oral tablet. The patient will take the prescription daily, at the same time.
Though small amounts of cholesterol are important for human life to occur, excess amounts can be detrimental. High cholesterol levels can lead to things like coronary heart disease, stroke, pe...
Stancu C and Sima A (2001) Statins: mechanism of action and effects Published in J.Cell.Mol.Med. Vol 5, No 4, 2001 pp. 378-387
There are many risk factors which can lead to the development of atherosclerosis. As can be expected, one of the risks factors for atherosclerosis is related to the abnormal level of blood lipids. The role of abnormal blood lipids in the development of atherosclerosis is providing the boost required for lipid to be transported to cells, as well as the production of reactive oxygen and free radicals (p.700). Moreover, the quantity of cholesterol carried by low-density lipoproteins (LDLs) in the arterial wall is critical in the development of atherosclerosis (McCance
Cardiovascular disease, also known as heart disease, is a term used for diseases involving the heart, arteries, capillaries and veins. The problems associated with cardiovascular disease are often a result of atherosclerosis. Atherosclerosis is caused by a buildup of plaque in artery walls, which disrupts blood flow through the arteries (American Heart Association, 2011). Cardiovascular disease causes a variety of conditions including heart attacks, ischemic stroke, heart failure, coronary artery disease, arrhythmias and heart valve problems (American Heart Association, 2011). These conditions lead to serious health related issues for individuals, including death. Every year there are around 600,000 individuals in the United States that die from cardiovascular disease, making heart disease the leading cause of death in both men and women (CDC, 2014). Although there are ways to decrease the risk of heart disease, the rate has been consistently increasing over the years, costing America billions of dollars in health care services annually. Contributing factors to the rise in heart disease includes the rate of obesity and a lack of physical activity (Dhaliwal, Welborn & Howat, 2013; Poirier, Giles, Bray, Hong, Pi-Sunyer & Eckel, 2006). These articles provide research that answers the question of how obesity and physical activity are linked to cardiovascular disease.
Six moths ago I scheduled a physical and blood work, a month later I was diagnosed with high cholesterol. My total cholesterol levels were at 250, with and LDL of 150, which puts me at a higher risk of cardiovascular illness. I was given the option of changing my eating habits with a combination of exercise to manage and lower my cholesterol levels, thus avoiding the need for medication. The dr. was very supportive, he had many helpful suggestions and showed me several ways in which I could lower my cholesterol by making simple food choices. After a long discussion I decided this was the way to go, I hate taking medication. When I reviewed the analysis report and saw that my cholesterol continues to be above the recommended range I let out a huge sigh, it took a few seconds to compose myself before I continued to look over it. This whole time I thought I had maintained my cholesterol under control, the analysis report proved that I was wrong. It is important that I make changes on how I eat. High cholesterol is indicative of cardiovascular illnesses that possibly result in serious chronic diseases. Diseases that are linked to high cholesterol are Coronary heart disease, peripheral vascular disease, diabetes and high blood pressure. The main risk from cholesterol is heart attacks. If the cholesterol remains high, it can build up overtime in the walls of the arteries forming a build up known as plaque. This plaque will cause the arteries
“If you’re at high risk for ischemic stroke, your doctor may prescribe drugs that reduce clots by interfering with the aggregation (clumping together) of blood cells called platelets” (Prevention of a Stroke 4). Your doctor would prescribe a specific type of medication called antiplatelet drugs. Anticoagulants (blood thinners), like antiplatelets, interfere with the formation of blood clots, but they work at a different stage in the clotting process- preventing the formation of fibrin, a protein that plays a role in blood clotting. “Statin medications lower blood cholesterol levels by blocking the activity of an enzyme crucial for the production of cholesterol by the liver. These medications also help stabilize plaques- the fatty deposits in arteries that can rupture and trigger the formation of a blood clot that can lead to a stroke” (Prevention of a Stroke 18). Statins are used to lower blood cholesterol levels and reduce inflammation in the artery walls. The medications your physician prescribes will depend on how great your risk of a stroke is as well as your risk of side effects from these
To slow the rate at which blood clots in a patient, a doctor may or may not administer a course of anticoagulant therapy. Anticoagulant therapy is a course of drugs taken by the patient, who might have one or more cardiovascular diseases, to prevent clots from forming. The most common use for anticoagulants is atrial fibrillation, an irregular heart rhythm [7]. They’re also administered for patients who have mechanical heart valves or patients who have blood clots [7]. There are many types of anticoagulants used, most commonly administered was Warfarin (Coumadin) [5]. However, due to recent advances in medicine many new anticoagulants have surfaced such as Apixaban, Dabigatran, Edoxaban, Rivaroxaban and many others [4]. Practitioners have more
But the numbers alone won't tell you or your doctor the whole story. High cholesterol is only one of a number of risk factors for heart attack and stroke.
Metabolic syndrome (MetS) is a combination of unfavo- rable health factors including abdominal obesity, dys- lipidemia, hypertension and glucose intolerance [1,2] and is strongly associated with increased risk of cardio- vascular disease (CVD) and type 2 diabetes [1,2]. One of the key drivers in the development of MetS is obesity [3]. In recent years, the global prevalence of obesity has increased at alarming rates, and MetS and its con- sequences have become a major public health burden [4,5]. This rise in MetS prevalence has also been ob- served in non-obese individuals [6-8] and there is strong evidence that the increase is mainly the result of un- favorable lifestyle changes, such as inactivity and poor nutrition [9].
When one or several lipids combine with proteins this forms lipoproteins, these transport fat throughout the bloodstream. High-density lipoproteins, also known as HDL, carry fat away from body cells, therefore preventing its growth in the artery walls. Low-Density Lipoproteins, also known as LDL, contain a high amount of cholesterol and seem to help the build up of fatty materials in the artery walls. The situation that you should go for would be high HDL and low LDL levels. Your goal should be to keep your overall cholesterol at below 200, with LDL lower than 40, and your HDL should be at around 160. This will lower the risk of heart disease and other related problems with cholesterol.
Frisinghelli, A., & Mafrici, A. (2007). Regression or Reduction in Progression of Atherosclerosis, and Avoidance of Coronary Events, With Lovastatin in Patients With or at High Risk of Cardiovascular Disease: AÂ Review. Clinical Drug Investigation, 27(9), 591-604.
Medicine net.com states that knowing "the amount of each type of cholesterol risk for disease and the total amount.” Therefore it is important to know the exact causes of high levels of LDL, that can include obesity, metabolic syndrome, and genetics. Having a high-fiber diet, as well as consuming plant-based foods can help lower the total LDL cholesterol levels, this in combination with an exercise regimen can then reduce the risk of developing the aforementioned
...lp to reduce the levels of low-density lipoprotein levels and potentially slow the development of atherosclerotic plaques in blood vessels16. With these advancements in pharmaceuticals, it may be much easier to control the advancement of atherosclerosis in future.