-
Medicine Dec 2022To understand the prevalent issues and challenges in the provision of care for dyslipidemia and hypertension in Vietnamese adults, quantification of patient journey... (Review)
Review
BACKGROUND
To understand the prevalent issues and challenges in the provision of care for dyslipidemia and hypertension in Vietnamese adults, quantification of patient journey stages (awareness, screening, diagnosis, treatment, adherence, and control) was performed in this semi-systematic review.
METHODS
The EMBASE and MEDLINE databases were searched for English articles published between 2010 and 2019. Thesis abstracts, letters to the editor, editorials, case studies, and studies on patient subgroups or nationally unrepresentative studies, were excluded. Articles from Google, the Incidence and Prevalence Database, the World Health Organization, Vietnam's Ministry of Health, and those suggested by the authors were also included. The last search was run on December 10, 2019 for dyslipidemia and hypertension.
RESULTS
A reviewer independently screened 586 retrievals for dyslipidemia and 177 retrievals for hypertension, and extracted data from 2 articles on dyslipidemia and 6 articles on hypertension that were included in the final synthesis.
CONCLUSION
The data generated in this review will help overcome these issues and barriers to patient care in populations with these 2 conditions.
Topics: Adult; Humans; Cardiovascular Diseases; Vietnam; Hypertension; Dyslipidemias
PubMed: 36595786
DOI: 10.1097/MD.0000000000032137 -
Current Opinion in Endocrinology,... Apr 2011Dyslipidemia is highly prevalent among patients living with chronic HIV infection and may confer increased risk of cardiovascular disease in this patient population.... (Review)
Review
PURPOSE OF REVIEW
Dyslipidemia is highly prevalent among patients living with chronic HIV infection and may confer increased risk of cardiovascular disease in this patient population. This review summarizes recent data investigating lipid abnormalities and its management in HIV-infected patients.
RECENT FINDINGS
Studies in the last year have evaluated the effects of various lipid-lowering therapies not previously investigated in the HIV patient population. Rosuvastatin is a potent statin that appears to be well tolerated and effective in HIV-infected patients with hypercholesterolemia.
SUMMARY
Dyslipidemia is common in HIV-infected individuals. Medical therapy of lipid disorders needs to take potential drug-drug interactions of lipid-lowering medications and antiretroviral agents into consideration.
Topics: Anti-HIV Agents; Biomarkers; Drug Interactions; Dyslipidemias; Evidence-Based Medicine; HIV Infections; Humans; Hypolipidemic Agents; Lipids; Risk Assessment; Treatment Outcome
PubMed: 21297466
DOI: 10.1097/MED.0b013e328344556e -
Reviews in Cardiovascular Medicine Mar 2021The risks for adverse thrombotic events, including myocardial infarction, stroke, and deep vein thrombosis, are markedly increased in dyslipidemia and other metabolic... (Review)
Review
The risks for adverse thrombotic events, including myocardial infarction, stroke, and deep vein thrombosis, are markedly increased in dyslipidemia and other metabolic disorders and are the major cause of death worldwide. Recent evidence points out that increased thrombotic risk in dyslipidemia is mediated by platelets circulating in a pre-activated state. The mechanisms of platelet reactivity in this setting are multifaceted including platelet activation by classic agonist receptor signaling as well as platelet sensitization by pattern recognition receptors. Elevated platelet counts in dyslipidemia due to dysregulation in hematopoiesis also contribute to the overall thrombotic phenotype. Despite recent advancements in antiplatelet and anticoagulation therapies, recurrences of adverse thrombotic events remain to be a large clinical burden. In the light of new knowledge, understanding mechanisms that drive pathologic thrombosis in dyslipidemia, the antithrombotic approach shall be revisited. Here, we discuss potential therapeutic avenues based on the overview of platelet signaling mechanisms that contribute to a prothrombotic phenotype in dyslipidemia.
Topics: Blood Platelets; Dyslipidemias; Humans; Platelet Activation; Platelet Aggregation Inhibitors; Signal Transduction; Thrombosis
PubMed: 33792249
DOI: 10.31083/j.rcm.2021.01.256 -
Genes Nov 2023Advances in pharmacogenomics have paved the way for personalized medicine. Cardiovascular diseases still represent the leading cause of mortality in the world. The aim... (Review)
Review
PURPOSE OF REVIEW
Advances in pharmacogenomics have paved the way for personalized medicine. Cardiovascular diseases still represent the leading cause of mortality in the world. The aim of this review is to summarize the background, rationale, and evidence of pharmacogenomics in cardiovascular medicine, in particular, the use of antiplatelet drugs, anticoagulants, and drugs used for the treatment of dyslipidemia.
RECENT FINDINGS
Randomized clinical trials have supported the role of a genotype-guided approach for antiplatelet therapy in patients with coronary heart disease undergoing percutaneous coronary interventions. Numerous studies demonstrate how the risk of ineffectiveness of new oral anticoagulants and vitamin K anticoagulants is linked to various genetic polymorphisms. Furthermore, there is growing evidence to support the association of some genetic variants and poor adherence to statin therapy, for example, due to the appearance of muscular symptoms. There is evidence for resistance to some drugs for the treatment of dyslipidemia, such as anti-PCSK9.
SUMMARY
Pharmacogenomics has the potential to improve patient care by providing the right drug to the right patient and could guide the identification of new drug therapies for cardiovascular disease. This is very important in cardiovascular diseases, which have high morbidity and mortality. The improvement in therapy could be reflected in the reduction of healthcare costs and patient mortality.
Topics: Humans; Pharmacogenetics; Cardiovascular Agents; Cardiovascular Diseases; Anticoagulants; Dyslipidemias
PubMed: 38003001
DOI: 10.3390/genes14112057 -
Lipids Oct 2010Atherogenic dyslipidemia comprises a triad of increased blood concentrations of small, dense low-density lipoprotein (LDL) particles, decreased high-density lipoprotein... (Review)
Review
Atherogenic dyslipidemia comprises a triad of increased blood concentrations of small, dense low-density lipoprotein (LDL) particles, decreased high-density lipoprotein (HDL) particles, and increased triglycerides. A typical feature of obesity, the metabolic syndrome, insulin resistance, and type 2 diabetes mellitus, atherogenic dyslipidemia has emerged as an important risk factor for myocardial infarction and cardiovascular disease. A number of genes have now been linked to this pattern of lipoprotein changes. Low-carbohydrate diets appear to have beneficial lipoprotein effects in individuals with atherogenic dyslipidemia, compared to high-carbohydrate diets, whereas the content of total fat or saturated fat in the diet appears to have little effect. Achieving a better understanding of the genetic and dietary influences underlying atherogenic dyslipidemia may provide clues to improved interventions to reduce the risk of cardiovascular disease in high-risk individuals.
Topics: Atherosclerosis; Cardiovascular Diseases; Diet; Dietary Fats; Dyslipidemias; Humans; Risk Factors
PubMed: 20524075
DOI: 10.1007/s11745-010-3408-1 -
The American Journal of Managed Care Jun 2007A literature review was undertaken to describe trends in the prevalence of dyslipidemia and the associated medical costs. The search focused on recent trials showing... (Review)
Review
A literature review was undertaken to describe trends in the prevalence of dyslipidemia and the associated medical costs. The search focused on recent trials showing effects of treatment on strokes and in patients with diabetes mellitus (DM). Online databases were searched for recent studies analyzing prevalence and/or cost of dyslipidemia, stroke, and DM. More than 43,000 papers have been written on dyslipidemia, with 700 considering costs and more than 100 focusing on the costs of dyslipidemia alongside stroke or DM. Findings in almost every case point toward high costs associated with dyslipidemia and cost-effective therapeutic options for treatment. The findings indicate that dyslipidemia is widespread and imposes substantial costs on the healthcare system. Treatment of elevated cholesterol and mixed lipid disorders using statins may relieve some of the burden, as recently noted for patients with DM and stroke.
Topics: Comorbidity; Cost-Benefit Analysis; Diabetes Mellitus; Dyslipidemias; Health Care Costs; Humans; Hypolipidemic Agents; Stroke; United States
PubMed: 17596114
DOI: No ID Found -
Neurologia 2022We present an update of the Spanish Society of Neurology's recommendations for prevention of both primary and secondary stroke in patients with dyslipidaemia.
OBJECTIVE
We present an update of the Spanish Society of Neurology's recommendations for prevention of both primary and secondary stroke in patients with dyslipidaemia.
DEVELOPMENT
We performed a systematic review to evaluate the main aspects of the management of dyslipidaemias in primary and secondary stroke prevention and establish a series of recommendations.
CONCLUSIONS
In primary prevention, the patient's vascular risk should be determined in order to define target values for low-density lipoprotein cholesterol. In secondary prevention after an atherothrombotic stroke, a target value <55 mg/dL is recommended; in non-atherothombotic ischaemic strokes, given the unclear relationship with dyslipidaemia, target value should be established according to the vascular risk group of each patient. In both primary and secondary prevention, statins are the drugs of first choice, and ezetimibe and/or PCSK9 inhibitors may be added in patients not achieving the target value.
Topics: Dyslipidemias; Humans; Neurology; PCSK9 Inhibitors; Proprotein Convertase 9; Stroke
PubMed: 35074190
DOI: 10.1016/j.nrleng.2020.07.021 -
Indian Heart Journal Mar 2024Lipid lowering therapies is well-established to prevent cardiovascular events in adults with dyslipidemia and multiple risk factors. However, global clinical usage of... (Review)
Review
Lipid lowering therapies is well-established to prevent cardiovascular events in adults with dyslipidemia and multiple risk factors. However, global clinical usage of LLT,particularly statins remains suboptimal, with adherence low rates for primary prevention and secondary prevention. Low adherence is influenced by concerns about side effects, misconceptions about benefits. Patients often discontinue statins due to perceived side effects, despite clinical trials showing no increase in symptoms compared to placebo. Poor understanding of statin benefits, doubts about their necessity, and suspicions of over prescription contribute to nonadherence, which is often amplified by negative portrayal of LLT specialy statins on social media. Strategies to improve adherence include addressing patient concerns, enhancing physician-patient communication, and increasing patient education. Optimizing statin usage and reducing the burden of cardiovascular disease necessitates addressing patient perceptions and improving communication between healthcare providers and patients.
Topics: Adult; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Dyslipidemias; Risk Factors; Lipids; Cardiovascular Diseases; Medication Adherence
PubMed: 38211773
DOI: 10.1016/j.ihj.2024.01.006 -
Scientific Reports Mar 2021Several studies have shown that probiotics and synbiotics ameliorate dyslipidemia. However, the molecular mechanisms mediating their effects remain to be determined....
Several studies have shown that probiotics and synbiotics ameliorate dyslipidemia. However, the molecular mechanisms mediating their effects remain to be determined. Therefore, we aimed to compare the effects of a probiotic, a prebiotic, and a synbiotic in dyslipidemic Sprague-Dawley rats, and explore the mechanisms involved using a proteomic approach. The rats were allocated to five groups: a control group that was fed normal chow, and four high-fat diet-fed groups, three of which were administered a probiotic (Lactobacillus acidophilus), a prebiotic (inulin), or a combination of the two (a synbiotic) for 30 days. We showed that the administration of inulin, and especially L. acidophilus, improved the lipid profile and reduced the serum concentrations of inflammatory markers in high-fat diet-fed rats. Proteomic analysis showed changes in lipid elongation, glycerolipid metabolism, activation of antioxidants, and a reduction in the activation of the mitogen-activated protein kinase signaling pathway in the livers of rats administered L. acidophilus, which likely mediate its beneficial effects on inflammation and dyslipidemia by reduced the levels of 18.56% CRP, 35.71% TNF-α 25.6% LDL-C and 28.57% LDL-C/HDL-C ratio when compared to HF group. L. acidophilus and inulin may represent effective natural means of maintaining inflammation and dyslipidemia.
Topics: Animals; Diet, High-Fat; Dyslipidemias; Inulin; Lactobacillus acidophilus; Prebiotics; Probiotics; Rats; Rats, Sprague-Dawley
PubMed: 33731756
DOI: 10.1038/s41598-021-85427-8 -
Indian Heart Journal Mar 2024Dyslipidemias are the most important coronary artery disease (CAD) risk factor. Proper management of dyslipidemia is crucial to control the epidemic of premature CAD in...
Dyslipidemias are the most important coronary artery disease (CAD) risk factor. Proper management of dyslipidemia is crucial to control the epidemic of premature CAD in India. Cardiological Society of India strived to develop consensus-based guidelines for better lipid management for CAD prevention and treatment. The executive summary provides a bird's eye-view of the 'CSI: Clinical Practice Guidelines for Dyslipidemia Management' published in this issue of the Indian Heart Journal. The summary is focused on the busy clinician and encourages evidence-based management of patients and high-risk individuals. The summary has serialized various aspects of lipid management including epidemiology and categorization of CAD risk. The focus is on management of specific dyslipidemias relevant to India-raised low density lipoprotein (LDL) cholesterol, non-high density lipoprotein cholesterol (non-HDL-C), apolipoproteins, triglycerides and lipoprotein(a). Drug therapies for lipid lowering (statins, non-statin drugs and other pharmaceutical agents) and lifestyle management (dietary interventions, physical activity and yoga) are summarized. Management of dyslipidemias in oft-neglected patient phenotypes-the elderly, young and children, and patients with comorbidities-stroke, peripheral arterial disease, kidney failure, posttransplant, HIV (Human immunodeficiency virus), Covid-19 and familial hypercholesterolemia is also presented. This consensus statement is based on major international guidelines (mainly European) and expert opinion of lipid management leaders from India with focus on the dictum: earlier the better, lower the better, longer the better and together the better. These consensus guidelines cannot replace the individual clinician judgement who remains the sole arbiter in management of the patient.
Topics: Aged; Child; Humans; Cholesterol; Coronary Artery Disease; Dyslipidemias; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Triglycerides; Practice Guidelines as Topic
PubMed: 38052658
DOI: 10.1016/j.ihj.2023.11.271