Cardiovascular disease hypercholesterolemia

Pharmacology DHEA supplementation has been advocated for a variety of indications, including Alzheimer s disease, cardiovascular disease, hypercholesterolemia, diabetes and insulin resistance, slowing or reversing the aging process, treatment of viral infections and cancers, and weight loss. For most of these indications, there is incomplete evidence for the efficacy of DHEA supplementation. For example, in elderly men DHEA increases free testosterone by 5-10%, but this effect has not been correlated with improvement of sexual functiem. 

The results of several large clinical trials using the statin drugs (discussed later) show that the tested drugs decreased the risk of both primary and secondary cardiovascular events. The incidence of myocardial infarction and death from cardiovascular disease was reduced in patients with hypercholesterolemia who never had a... 

Alpha-1 antitrypsin deficiency Cardiovascular diseases Familial hypercholesterolemia Many types using vaccine, toxin or endogenous regulatory protein expression strategies... 

Fluvastatin (Fig. 21) is a member of the drug class of statins used to treat hypercholesterolemia and to prevent cardiovascular disease. It is able to decrease ROS, such as hydroxyl radicals and superoxide anions generated by the Fenton reaction, and by the xanthine-xanthine oxidase system. The an-tioxidative effect of fluvastatin was thought to have caused not only the scav-... 

Type I lipoproteinemia is generally caused by the inability of the organism to clear chylomicrons. The problem may be defective ApoC-II or a defective lipoprotein lipase. Very often, chylomicron clearance may be affected by injection of heparin, which apparently releases hepatic lipase from the liver into the circulation. ApoE disorders may be associated with type III lipoproteinemia, in which clearance of IDL is impeded. Increases in circulatory LDL are usually caused by a decrease in tissue receptors specific for ApoB-100. An extreme case of type Ha hyperlipoproteinemia is familial hypercholesterolemia, in which serum cholesterol levels may be as high as 1000 mg/dL and the subjects may die in adolescence from cardiovascular disease. There is total absence of ApoB-100 receptors. Mild type Ila and lib lipoproteinemias are the most commonly occurring primary lipoproteinemias in the general population. 

The primary goal of therapy is the control of the hypercholesterolemia and prevention of atherosclerotic cardiovascular disease. Patients with heterozygous FH can usually be successfully treated with medications to lower the LDL cholesterol to acceptable levels (Table 14-2). They are generally responsive to treatment with statins, alone or in combination with other drugs, such as bile acid sequestrants (such as cholestyramine) or cholesterol absorption inhibitors (such as ezetimibe) that act additively to upregulate the expression of the functioning LDL receptor as described in the Biochemical Perspectives section. In a few cases, a more aggressive treatment with LDL apheresis (discussed in this section) may have to be considered in order to reach acceptable LDL cholesterol levels. 

Currently promoted uses of OEP include EFA deficiency mastalgia, fibrocystic breast disease, endometriosis, menopause, premenstrual syndrome (PMS), and the prevention of preeclampsia, diabetic neuropathy, psoriasis, eczema/dermatitis, rheumatoid arthritis, cardiovascular disease, gastrointestinal disorders, attention deficit disorder in children, and hypercholesterolemia (5,7). OEP is used topically as an ingredient in some soaps, cosmetics and medicinals. 

The Total Plasma and LDL-Cholesterol Levels in Children and Adolescents from Families with Hypercholesterolemia or Premature Cardiovascular Disease ... 

Familial hypercholesterolemia is caused by mutations In the gene encoding the low-density lipoprotein (LDL) receptor. Persons with this disorder have elevated plasma LDL levels and develop cardiovascular disease at abnormally young ages. 

In addition to diabetes mellitus, Mr. Applebod has a hyperlipidemia (high blood lipid level—elevated cholesterol and triacylglycerols), another risk factor for cardiovascular disease. A genetic basis for Mr. Applebod s disorder is inferred from a positive family history of hypercholesterolemia and premature coronary artery disease in a brother. 

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