Hyperlipidemia documentation

Although treatment of hyperlipidemia can cause slow physical regression of plaques, the well-documented reduction in acute coronary events that follows vigorous lipid-lowering treatment is attributable chiefly to mitigation of the inflammatory activity of macrophages and is evident within 2-3 months after starting therapy. 

The use of plant sterols—(3-sitostcrol and sitostanol in consumer products to decrease cholesterol is supported by numerous clinical studies that document their efficacy in lowering mild hyperlipidemia (Jones et al., 1998 Hallikainen and Uusitupa, 1999). Although the normal diet contains plant sterols that range from 160 to 360 mg/day, a 5- to 10-fold increase is required to exert a cholesterol-lowering effect. Consumer products with increased amounts of phytosterols that exceed the content found in the diet have been made available to the consumer. In evaluating the efficacy of including sitostanol ester in margarine as a dietary supplement for children with familial hypercholesterolemia (FH), it was found that serum total cholesterol (TC), intermediate density lipoprotein-cholesterol and LDL-cholesterol levels fell while the HDL-cholesterol/LDL-cholesterol ratio was elevated. 

For pharmacists, the message is clear To improve adherence to pharmacotherapy, and hence to improve health outcomes, we must assess each patient individually, then provide targeted interventions that are responsive to his or her unique risk factors and needs (see Fig. 1). Research, such as the American Pharmaceutical Association Foundation s Project ImPACT Hyperlipidemia, has clearly documented the value of pharmacist-led patient care in fostering better adherence and outcomes. 

However, it must be said that most of the literature considered in this chapter refers to experimental work performed with cell lines or in vivo by means of rodent models. Both PPARot and SREBP-lc are very attractive drug targets. Therefore, it would be of crucial interest to document their respective gender and species-specificity. PPARot activators such as fibrates are currently widely prescribed drugs for human hyperlipidemia. To our knowledge, there is no current use of drugs targeting SREBPlc. 

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