Cholesterol agents that elevate

The recent years have seen the success of statins like Lipitor (atorvastatin) as hypolipidemic agents that help treating cardiovascular disease primarily by lowering low-density lipoproteins ( bad cholesterol ) levels. Another novel strategy is to tackle the same problem by elevating high-density lipoproteins (H D L or good cholesterol ) levels via inhibition of cholesteryl ester transfer protein (CETP). 

Ezetimibe is an antihyperlipidemic agent that inhibits absorption of cholesterol by the small intestine. It is indicated to be administered alone or with HMG-CoA reductase inhibitors as adjnnctive therapy to diet for reduction of elevated total cholesterol, LDL, and apolipoprotein (Apo) in patients with primary hypercholesterolemia with atorv-astatin or simvastatin for the reduction of elevated total cholesterol and LDL levels in patients with homozygous familial hypercholesterolemia as an adjunct to other lipidlowering treatments or if such treatments are unavailable and as adjnnctive therapy to diet for the reduction of elevated sitosterol and campesterol levels in patients with homozygons familial sitosterolemia. 

Older primary prevention trials had often been undertaken in cohorts at low absolute risk of CHD events. The initial secondary prevention studies had typically involved patients with elevated cholesterol levels. In addition, these older trials had tested diet and previous lipid-lowering agents, which only lowered cholesterol by an average of approximately 10% (5). As a consequence, these trials were typically underpowered and had not shown a clear reduction in all-cause mortality. There had been good evidence that lipid-modifying therapy could prevent fatal and nonfatal CHD events (5). However, there were some concerns that noncardiovascular events particularly related to cancers and violence or trauma could be increased. In summary, there was considerable uncertainty about the overall effects of treatment. 

Evidence is accumulating that inositol will reduce elevated hlood cholesterol levels. This in turn may prevent or mitigate cholesterol depositions in (he intima of blood vessels in humans and animals and. theiefore, be of value in atherosclerosis. Inositol has also been considered a lipotropic agent. Because humans can synthesixe inositol, the need for it as a nutritional requireinent has not been proved. ... 

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