Lipids and Atherosclerosis: Lessons Learned from Randomized Controlled Trials of Lipid Lowering and Other Relevant Studies
| Autor: | Albert Oberman, Robert A. Kreisberg |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism Clinical Biochemistry Population Biochemistry law.invention Coronary artery disease chemistry.chemical_compound Endocrinology Randomized controlled trial law Internal medicine medicine Clinical endpoint cardiovascular diseases education Coronary atherosclerosis education.field_of_study Cholesterol business.industry Biochemistry (medical) medicine.disease Clinical trial chemistry Lipid hypothesis lipids (amino acids peptides and proteins) business |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 87:423-437 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Despite evidence from population studies and clinical trials dating to 1984 (1), The Lipid Hypothesis, the idea that a reduction in blood cholesterol reduced coronary heart disease (CHD) risk was viewed with skepticism. Subsequently, angiographic studies using a range of drug and lifestyle regimens demonstrated that progression of coronary atherosclerosis could be reduced and clinical cardiac events prevented. A new and expanded opportunity for the treatment of hypercholesterolemia and prevention of CHD emerged with the use of statins. The landmark Scandinavian Simvastatin Survival Study (4S) was the first randomized, controlled trial to convincingly demonstrate that coronary events and total mortality were decreased by a reduction in low-density lipoprotein cholesterol (LDL-C) (2). Within the past decade, major clinical endpoint trials (2–7), enrolling more than 30,000 patients, have emphasized the value of LDL-C reduction. This reduction in CHD is particularly noteworthy because total and LDL-C reduction were accomplished with a variety of drugs (statins, fibrates, and bile acidbinding resins), dietary changes, lifestyle modifications, and surgery (ileal bypass), indicating that reduction in cholesterol and LDL-C was more important than how it was achieved. CHD events, cardiovascular morbidity and mortality, and all-cause mortality can be prevented with statins or fibrates in patients with average or elevated LDL-C who have preexisting CHD |
| Databáze: | OpenAIRE |
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