Blood, cholesterol

The first application of the Gaussian distribution is in medical decision making or diagnosis. We wish to determine whether a patient is at risk because of the high cholesterol content of his blood. We need several pieces of input information an expected or normal blood cholesterol, the standard deviation associated with the normal blood cholesterol count, and the blood cholesterol count of the patient. When we apply our analysis, we shall anive at a diagnosis, either yes or no, the patient is at risk or is not at risk. 

Guanfacine. Guanfaciae, used ia patients having mild to moderate hypertension, can lower blood pressure 50/25 mm Hg (systoHc/diastoHc) ia hypertensive patients. Side effects such as sedation, dry mouth, and asthenia are less as compared to those of guanaben2 and clonidine. Guanfaciae reduces blood cholesterol and triglyceride and does not cause glucose iatolerance. 

Antimony 0.006 0.006 Increase in blood cholesterol decrease in blood glucose Discharge from petroleum refineries fire retardants ... 

Cold-water frsh like salmon are rich in omega-3 fatty acids, which have a double bond three carbons in from the noncarboxyl end of the chain and have been shown to lower blood cholesterol levels. Draw the structure of 5,8,11,14,17-eicosapentaenoic acid, a common example. (Eicosane = C20H42)... 

An increase in serum lipids is believed to contribute to or cause atherosclerosis, a disease characterized by deposits of fatty plaques on the inner walls of arteries. These deposits result in a narrowing of the lumen (inside diameter) of the artery and a decrease in blood supply to the area served by the artery. When these fatty deposits occur in the coronary arteries, the patient experiences coronary artery disease. Lowering blood cholesterol levels can arrest or reverse atherosclerosis in the vessels and can significantly decrease the incidence of heart disease. 

The patient will usually take these drugs on an outpatient basis and come to the clinic or the primary health care provider s office for periodic monitoring. Frequent monitoring of blood cholesterol and triglyceride levels is done as a part of the ongoing assessment. 

Using Diet and Drugs to Control High Blood Cholesterol Levels... 

Emphasizes that drug therapy alone will not significantly lower blood cholesterol levels. 

The larger the benefit, the smaller the number of subjects required to show statistical significance. For example, if a herbal supplement is expected to produce a 5% lowering of the blood cholesterol level vs placebo, this will require many more subjects than a study evaluating the effects of a drug that is expected to produce a 50% reduction vs placebo. 

Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001 285 2486-2497. 

Patients with high blood cholesterol levels may need to use the Step II diet to achieve further reductions in LDL-cholesterol levels in the Step II diet, saturated fats are reduced to less than 7% of total calories, and cholesterol levels to less than 200 mg/day. All of the other nutrients are the same as in Step I. 

Pectin, the substance that makes jellies and jams so jelly-like, can help lower blood cholesterol levels by forcing the body to make more bile acids. Pectin is a type of fiber, and like most fiber, pectin cannot be digested by the human body. Instead, the fiber moves slowly through the small intestines. When pectin encounters sugar and acid, its molecules trap water within its long chains, turning into a gel-like mass. This gel traps and eventually eliminates bile acids from the gut. When this happens, the body must make more bile acids, reducing the amount of cholesterol in the blood. 

Pectin is found in apples and in the white membrane that surrounds the sections of oranges, grapefruits, or other citrus fruits, as well as in several other sources. Powdered pectin made from apple cores is also available, but scientists have found that eating apples or citrus fruit has a much better effect on lowering blood cholesterol levels than eating powered pectin does. They believe eating the whole fruit is better because the body also needs vitamin C to convert cholesterol into bile acids. Fruits contain vitamin C, or ascorbic acid, but the powdered pectin does not. 

Lindahl, B., Johansson, I., Huhtasaari, F., Hallmans, G., Asplund, K., Coffee drinking and blood cholesterol - effects of brewing method, food intake and life style. J Internal Medicine, 230, 299, 1991... 

Cocco PL, Cocco E, Anni MS, et al. 1991. Occupational exposure to lead and blood cholesterol in glucose-6-phosphate dehydrogenase deficient and normal subjects. Res Commun Chem Pathol Pharmacol 72(1) 81-95. 

Monounsaturated fats in avocados have been shown to reduce blood cholesterol while preserving the level of high-density lipoproteins (Yahia 2009b). An avocado-enriched diet produced a significant reduction in LDL and total cholesterol in patients with high cholesterol levels, whereas diets enriched with soy and sunflower did not change the total cholesterol concentrations (Carranza and others 1997). 

Plat J and Mensink RP. 2005. Plant stand and sterol esters in the control of blood cholesterol levels mechanism and safety aspects. Am J Cardiol 96(1) 15D-22D. 

When dietary fibre became a nutrition issue it was assumed that the insoluble fibre such as bran was the most beneficial subcomponents. It now appears that soluble fibres can lower blood cholesterol while insoluble fibre such as wheat bran merely speeds up the transit of food through the gut. Developments in this area are awaited. 

Which of the following drugs recommended for the lowering of blood cholesterol inhibits the synthesis of cholesterol by blocking 3-hydroxy-3-me thy 1 glutary 1-coenzyme A (HMG-CoA) reductase ... 

The answer is d, (Hardman, pp 934-935.) Chenodeoxycholic acid (chenodiol) and ursodiol have proved to he effective in some patients with cholesterol gallstones. Lovastatin lowers blood cholesterol levels but has no effect on gallstones. Methyl tertiary butyl ether and a new agent, monoctanoin, are infused directly into the common duct and will dissolve gallstones. 

If the total cholesterol is <200 mg/dL, then the patient has a desirable blood cholesterol level (Table 9-1). If the HDL is also >40 mg/dL, no further follow-up is recommended for patients without known CHD and who have fewer than two risk factors (Table 9-2). 

---