• Title/Summary/Keyword: Lipid-lowering therapy

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Statin Intolerance: an Overview of the Current Status and Possible Treatment Options

  • Suh, Sunghwan;Jung, Chang Hee;Hong, Soon-Jun;Kim, Jung-Sun;Choi, Sung Hee
    • Journal of Lipid and Atherosclerosis
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    • v.7 no.2
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    • pp.77-87
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    • 2018
  • Lowering serum low-density lipoprotein cholesterol (LDL-C) is the mainstay for reduction of risk of cardiovascular disease (CVD), the second most common cause of death in Korea. The 2015 Korean guidelines for management of dyslipidemia strongly recommend the use of statins in patients at risk of CVD. Statin therapy, which is the gold standard for CVD, reduces LDL-C level by 40% to 60% and is generally well tolerated. However, many patients are intolerant to statins and discontinue therapy or become nonadherent to therapy because of actual/perceived side effects. The most common of these side effects is the statin-associated muscle symptom (SAMS). Discontinuation and repetitive re-challenge with statins can help identify SAMS. If serum creatinine kinase level is more than 10 times the upper limit of normal, statin therapy must be stopped immediately, and the physician should identify possible causes including rhabdomyolysis and treat appropriately. In other patients, it might help to switch to a less potent statin or to use statins at intermittent non-daily dosing. To achieve target LDL-C level, non-statin lipid-lowering therapies such as dietary modifications, ezetimibe, and bile acid sequestrants may be added. Several new drugs have recently been approved for lowering LDL-C level. Alirocumab and evolocumab are monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9, and both drugs cause large reductions in LDL-C, similar to statins. Lomitapide and mipomersen are orphan drugs used as adjuncts to other lipid-lowering therapies in patients with homozygous familial hypercholesterolemia.

Menopausal Hormone Therapy for Preventing Weight Gain and Cardiovascular Disease (체중과 심혈관 질환에 대한 폐경기 호르몬 요법의 효과)

  • Yeong Sook Yoon
    • Archives of Obesity and Metabolism
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    • v.2 no.2
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    • pp.54-63
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    • 2023
  • Estrogen is crucial in regulating food intake, energy expenditure, glucose metabolism, and lipid metabolism. During menopause, the decline in estrogen levels predisposes women to weight gain, abdominal obesity, insulin resistance, type 2 diabetes, hypertension, and cardiovascular disease (CVD). Menopausal hormone therapy (MHT) prevents weight gain, improves lipid metabolism by lowering low-density lipoprotein cholesterol while raising high-density lipoprotein cholesterol, and delays the onset of type 2 diabetes in menopausal women. The effect of MHT on CVD in menopausal women remains controversial. The Women's Health Initiative study was terminated prematurely after it revealed that hormone administration increased the risk of myocardial infarction, stroke, and thromboembolism. However, some studies have found that MHT had no effect or decreased the risk of CVD. The inconsistent results were likely due to multiple factors, including the timing of hormone therapy initiation, duration of therapy, type and dosage, and presence or absence of CVD risk factors at the start of treatment. Despite its benefits in terms of managing weight gain and reducing the risk of type 2 diabetes, dyslipidemia, and CVD associated with obesity, it is not recommended as the primary therapy for weight loss or diabetes prevention. MHT is primarily indicated for postmenopausal women, who are likely to benefit from its potential to prevent weight gain and improve lipid metabolism.

Effects of Medical Nutrition Therapy on Food Habits and Serum Lipid Levels of Hypercholesterolemic Patients (영양교육이 고콜레스테롤혈증 환자의 식습관 및 혈청 지질 농도에 미치는 영향)

  • Kim, So-Yeon;Son, Jeong-Min;Jeong, U-Yeong
    • Journal of the Korean Dietetic Association
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    • v.11 no.1
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    • pp.125-132
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    • 2005
  • Hypercholesterolemia has been regarded as a major risk factor of coronary heart disease(CHD). CHD is increasing in recent years among Koreans due to westernization of lifestyle and dietary behaviors. In the United States, implementation of the National Cholesterol Education Program(NCEP) had resulted 40% decline in mortality from CHD. This study was designed to evaluate the effect of medical nutrition therapy on serum lipid levels and discuss the effective nutrition education contents. Thirty outpatients(Male 40%, female 60%) with hypercholesterolemia were educated by medical nutrition therapy(MNT) protocol. At first visit and after three months of MNT, we assessed serum lipid profile, body weight and surveyed general characteristics, lifestyle and food habits through questionnaire. After 12 weeks of MNT, there were significant reductions in serum cholesterol and low-density lipoprotein cholesterol(LDL-C). Foods habits and lifestyle were changed to the desirable patterns. These results indicate that lipid profile is improved by changes of dietary behaviors and lifestyle. Especially in case of obesity, cholesterol lowering effect of MNT was more powerful. Consequently, MNT is effective on reduction of serum lipids by behavior change in hypercholesterolemic patients.

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Combined Lowering Effects of Rosuvastatin and L. acidophilus on Cholesterol Levels in Rat

  • Wang, Lijun;Zhou, Baihua;Zhou, Xue;Wang, Yang;Wang, Hongwei;Jia, Shengying;Zhang, Zhipeng;Chu, Chao;Mu, Jianjun
    • Journal of Microbiology and Biotechnology
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    • v.29 no.3
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    • pp.473-481
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    • 2019
  • Statins are a class of lipid-lowering drugs commonly used in the prevention of cardiovascular diseases. However, statin therapy presents many limitations, which have led to an increased interest in non-drug therapies, such as probiotics, to improve blood cholesterol levels. Indeed, probiotic strains such as Lactobacillus acidophilus have been found to improve blood lipid profiles, especially in reducing total cholesterol and LDL-C levels. In this study, we established a high-cholesterol rat model and studied the effect of Lactobacillus acidophilus administration alone or in combination with rosuvastatin. We were able to show that Lactobacillus exerts a cholesterol-lowering effect. Additionally, we observed that when administered together, rosuvastin and Lactobacillus exert a combined cholesterol-lowering effect. Altogether, our data advocate for the possibility of establishing probiotics as non-drug supplements for the treatment of hypercholesterolemia.

Development and assessment of nano drug delivery systems for combined delivery of rosuvastatin and ezetimibe

  • Mohamed Ali Metwally;El-Yamani Ibrahim El-Zawahry;Maher Amer Ali;Diaa Farrag Ibrahim;Shereen Ahmed Sabry;Omnia Mohamed Sarhan
    • The Korean Journal of Physiology and Pharmacology
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    • v.28 no.3
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    • pp.275-284
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    • 2024
  • Worldwide, cardiovascular disease is the main cause of death, which accordingly increased by hyperlipidemia. Hyperlipidemia therapy can include lifestyle changes and medications to control cholesterol levels. Statins are the medications of the first choice for dealing with lipid abnormalities. Rosuvastatin founds to control high lipid levels by hindering liver production of cholesterol and to achieve the targeted levels of low-density lipoprotein cholesterol, another lipid lowering agents named ezetimibe may be used as an added therapy. Both rosuvastatin and ezetimibe have low bioavailability which will stand as barrier to decrease cholesterol levels, because of such depictions, formulations of this combined therapy in nanotechnology will be of a great assistance. Our study demonstrated preparations of nanoparticles of this combined therapy, showing their physical characterizations, and examined their behavior in laboratory conditions and vivo habitation. The mean particle size was uniform, polydispersity index and zeta potential of formulations were found to be in the ranges of (0.181-0.72) and (-13.4 to -6.24), respectively. Acceptable limits of entrapment efficiency were affirmed with appearance of spherical and uniform nanoparticles. In vitro testing showed a sustained release of drug exceeded 90% over 24 h. In vivo study revealed an enhanced dissolution and bioavailability from loaded nanoparticles, which was evidenced by calculated pharmacokinetic parameters using triton for hyperlipidemia induction. Stability studies were performed and assured that the formulations are kept the same up to one month. Therefore, nano formulations is a suitable transporter for combined therapy of rosuvastatin and ezetimibe with improvement in their dissolution and bioavailability.

Effect of Dietary Therapy on Blood Lipid in Outpatients with Hypercholesterolemia (고콜레스테롤혈증 환자에서 식사요법이 혈청 지질농도에 미치는 영향)

  • Im, Hyeon-Suk;Sin, Min-Jeong;Jeong, Nam-Sik;Jo, Seung-Yeon;Kim, Seong-Sun
    • Journal of the Korean Dietetic Association
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    • v.7 no.4
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    • pp.313-319
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    • 2001
  • High serum cholesterol level is a major risk factor for coronary heart disease(CHD). Nutrition therapy of hypocholesterolemic diets with increased physical activity is the essential step in the treatment of the hypercholesterolemic patients. The purpose of this study was to evaluate the short-term effect of intensive dietary therapy combined with regular exercise in lowering serum cholesterol level. Seventy three hypercholesterolemic outpatients(mean: 268.0$\pm$24.7mg/dL), aged 34 to 73(mean: 56$\pm$9.8yrs), who visited cardiology OPD of Yonsei Cardiovascular Center from April through October, 1998 were studied. Anthropometric measurements, usual nutrient intake survey using semiquantitative food frequency questionnaire, and daily nutrient intake analysis were performed. The nutrition counseling for the hypocholesterolemic diet and exercise therapy was performed individually. After a 4 week intensive dietary therapy, comparisons of body weight, nutrient intakes, and blood lipid concentrations were evaluated for the hypocholesterolemic effect of intensive diet therapy. After 4 weeks of intensive diet therapy, significant reductions in percent ideal body weight(p<0.01), saturated fat intake(p<0.01), and cholesterol intake(p<0.01) were observed. There were significant reductions in serum total cholesterol and LDL-cholesterol levels after 4 weeks of therapy by 8.1%(p<0.01) and 9.7%(p<0.01), respectively. Our results showed that intensive dietary therapy was effective in reductions of serum total and LDL-cholesterol levels. The goal for this dietary modification should not be temporary but rather be permanent in eating behavior accompanied by appropriately increased physical activity.

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Screening, Diagnosis, and Treatment of Familial Hypercholesterolemia: Symposium of the Education Committee, Korean Society of Lipid and Atherosclerosis (가족성 고콜레스테롤혈증의 스크린, 진단, 치료: 한국지질동맥경화학회 교육위원회 심포지엄)

  • Lee, Chan Joo;Lee, Ji Hyun;Choi, Seonghoon;Kim, Shin-Hye;Kang, Hyun-Jae;Lee, Sang-Hak;Park, Kyong Soo
    • Journal of Lipid and Atherosclerosis
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    • v.7 no.2
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    • pp.122-154
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    • 2018
  • Familial hypercholesterolemia (FH) is typically associated with single gene mutation that is inherited by autosomal dominant manner. Due to high cardiovascular risk, aggressive discovery, diagnosis, and treatment of FH are critical. Although FH is being increasingly spotlighted, we do not have sufficient data on Korean patients with FH. Here, we present the content of symposium of the Education Committee, Korean Society of Lipid and Atherosclerosis held in May 2018: 1) epidemiology, clinical diagnosis, Korean FH data, and regulation in Korea; 2) genes associated with FH, sequencing process in suspicious proband, cascade screening, and difficulty in genetic diagnosis in FH; 3) the importance of lipid-lowering therapy in FH, conventional and novel therapeutics for FH; 4) diagnosis of FH in children and adolescence, screening, and treatment of FH in children and adolescence; 5) history of FH studies in Korea, the structure and current status of FH registry of Korean Society of Lipid and Atherosclerosis; and 6) difficulty in diagnosis of heterozygous and homozygous FH, drug intolerance and achievement of treatment target. Discussion between speakers and panels were also added. We hope that this article is helpful for understanding FH and future studies performed in Korea.

Current Guidelines on the Management of Dyslipidemia (이상지질혈증의 국내 및 국외 치료 가이드라인 비교)

  • Choi, Yunjeong;Lee, Song;Kim, Ju Young;Lee, Kyung Eun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.276-283
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    • 2017
  • Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

Development of Yak-Sun for Excess Syndrome Obesity (1) Effects of Weight, Serum Glucose, Insulin and Lipid Profiles of Oriental Medicinal Herbs with Removal of Dampness through Diuresis (실증성(實證性) 비만을 위한 약선식 개발에 관한 연구 (1) 이습(利濕) 작용이 있는 한약재 혼합 추출물이 체중과 혈청 포도당, 인슐린 농도 및 지질 조성에 미치는 효과)

  • Park Sung-Hye
    • Journal of the East Asian Society of Dietary Life
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    • v.15 no.6
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    • pp.700-706
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    • 2005
  • We are concerned about how to apply the theories of oriental medicine appropriately, which direction should it be taken, and how it should be developed. And it is believed to be essential for the government to make efforts to set a standard and laws to validate the medicinal effects and process of the assessment so that the systematic development can be encouraged, and to prepare guidance for the food development for national health improvement Ihis study was peformed to provide basic data that predict the usefulness of oriental medicinal herbs to remove the dampness through diuresis for excess syndrome obesity with oriental diet therapy cuisine(Yak-Sun). Five oriental medicininal herbs, Coix lachryma-jobi L, Atractylodes lancea DC., Ligusticum wallichii F., Angelica sinensis D., Zingiber officinale R. were collected and made into mixing extracts(OMCE). And we examined the effects of OMCE on body weight serum glucose, insulin and lipid profile improvement in rats fed high fat diets. Sprague-Dawley rae(230-250 g) were randomly divided into five groups : basal diet(normal diet control group, NCG), only high fat diet(High fat control group, HCG), high fat diet and supplemented with 25mg/100g body weight 50mg/100g body weight 75mg/100g body weight by OMCE(HLG, HMG, HHG). These experimental diets were fed for 6 weeks. The OME fed groups decreased more significantly in weight serum glucose insulin and lipids than the high fat control group did. These results imply that the OMCE can be used as a safe and clinically applicable ingredients for diet called Yaksun of excess syndrome obesity in human.

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