Cholesterol最新文献

Treatment of cardiovascular disease, albeit under the auspices of other clinical descriptors to those described in western biomedicine, has a long history in China. Chinese Medicine (CM) is guided by unique philosophical underpinnings and theories. There are differences in how the heart is conceptualised traditionally in CM compared to biomedicine. This paper focusses on how hypercholesterolemia is understood from within the Chinese medical paradigm, including its aetiology, pathogenesis, and treatment. A brief overview of the key characteristics and theories of CM is given to provide context. Modern science has demonstrated that many Chinese herbs have cholesterol-lowering properties. Examples of research into individual herbs and medicinal formulae, combinations of herbs are presented. At a more sophisticated level, some researchers are challenging some of the very assumptions upon which CM is based, including applicability of CM theory to modern clinical entities such as hypercholesterolemia, and are seeking intersections of knowledge between CM and biomedicine that may extend CM theory.

Many infections favor or are directly implicated with lipid metabolism perturbations and/or increased risk of coronary heart disease (CHD). HIV itself has been shown to increase lipogenesis in the liver and to alter the lipid profile, while the presence of unsafe habits, addiction, comorbidities, and AIDS-related diseases increases substantially the risk of cardiovascular disease (CVD) in the HIV-infected population. Antiretroviral therapy reduces such stimuli but many drugs have intrinsic toxicity profiles impacting on metabolism or potential direct cardiotoxicity. In a moment when the main guidelines of HIV therapy are predating the point when to start treating, we mean to highlight the contribution of HIV-1 to lipid alteration and inflammation, the impact of antiretroviral therapy, the decisions on what drugs to use to reduce the probability of having a cardiovascular event, the increasing use of statins and fibrates in HIV-1 infected subjects, and finally the switch strategies, that balance effectiveness and toxicity to move the decision to change HIV drugs. Early treatment might reduce the negative effect of HIV on overall cardiovascular risk but may also evidence the impact of drugs, and the final balance (reduction or increase in CHD and lipid abnormalities) is not known up to date.

Objective. To assess the effectiveness of niacin/fish oil combination therapy in reducing Lipoprotein (a) [Lp(a)] levels after twelve weeks of therapy. Background. Lipoprotein (a) accumulates in atherosclerotic lesions and promotes smooth muscle cell growth and is both atherogenic and thrombogenic. A clinical trials of combination therapy for the reduction of Lp(a) has not been previously reported. Methods. The study was an observational study following subjects with an elevated Lp(a) (>70 nmol/L) to assess impact of 12 weeks of combination Omega 3FA, niacin, and the Mediterranean diet on Lp(a). Results. Twenty three patients were enrolled with 7 patients lost to follow up and 2 patients stopped due to adverse events. The average Lp(a) reduction in the remaining 14 subjects after 12 weeks of combination therapy was 23%  ± 17% [P = .003] with a significant association of the reduction of Lp(a) with increasing baseline levels of Lp(a) [R(2) = 0.633, P = .001]. Conclusions. There was a significant reduction in Lp(a) levels with combination therapy. A more pronounced effect was noted in patients with higher baseline levels of Lp(a).