High blood cholesterol

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

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. 

In patients with borderline-high blood cholesterol (200 to 239 mg/dL), assessment of risk factors is needed to more clearly define disease risk. 

Schulman KA, Kinosian BP, Jacobson TA, Glick HA, Willian MK, Koffer H et al. Reducing high blood cholesterol level with drugs cost effectiveness of pharmacologic management. JAMA 1990 264 3025-33. 

National Institnte of Health. Third Report of the National Cholesterol Edncation Program Expert Panel on detection, evalnation and treatment of high blood cholesterol in adnlt (Adnlts Treatment Panel III). Executive Summary. NIH publication no 01-3670. Bethesda (MD) National Institnte of Health, National Heart, Lung and Blood Institnte 2001. 

Report of the National Cholesterol Education Program Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults. 

A proper balance of cholesterol in the bloodstream requires having an adequate balance of receptors to process the amount of cholesterol in the blood. Receptors are continually regenerated, produced, and disappear in the cell in response to blood biochemistry. The liver contains the greatest concentration of receptors. Too few receptors or excess dietary cholesterol intake can lead to elevated blood cholesterol. A genetic disorder called familial hypercholesterolemia results when a person inherits a defective gene from one parent resulting in the inability to produce sufficient receptors. A diet with too much cholesterol represses the production of LDL receptors and leads to high blood cholesterol and Apo B. 

Until 1993 apolipoprotein E was best known for its central role in plasma lipoproteins and cholesterol transport (Fig. 21-1). However, one of the three common alleles of the apoE gene confers a significant risk of development of Alzheimer disease.12171218 A high blood cholesterol level is also correlated with increased risk.12191220 Membrane abnormalities in mitochondria have been associated with Alzheimer disease.1221 Also related to membranes and lipid metabolism, vitamin E appears to combat Alzheimer disease.843 1218... 

The measurement of serum cholesterol is one of the most common tests performed in the clinical laboratory. Hypercholesterolemia (high blood cholesterol levels) can be the result of a variety of medical conditions. Among the conditions implicated are diabetes mellitus, atherosclerosis, and diseases of the endocrine system, liver, or kidney. High blood cholesterol levels do not point to a specific disease determination of cholesterol is used in conjunction with other clinical measurements mainly for confirmation of a particular diseased condition, rather than for diagnosis of a specific ailment. 

The Expert Panel in summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evalution, and treatment of high blood cholesterol in adults (adult treatment panel II) (1993) J Am Med Assoc 269 3015... 

Antiseptic reduces high blood pressure and high blood cholesterol... 

This is an inherited disorder in which individuals have a lack of functional LDL receptors preventing cholesterol from being taken up by the tissues. The resulting high blood cholesterol level leads to an increase in the formation of atheromas and can cause death from myocardial infarction during childhood. 

It has been clear for several decades that an elevated concentration of plasma cholesterol attributable to increased concentrations of atherogenic lipoproteins (low-density lipoproteins [LDL] and remnant lipoproteins) is a major risk factor for the development of coronary heart disease (CHD) (Castelli et al., 1992 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 1993). The cholesterol biosynthetic pathway (Fig. 1) was a natural target in the search for drugs to reduce plasma cholesterol concentrations in the hope that these treatments would reduce the risk of CHD. However, early attempts to reduce cholesterol biosynthesis were disastrous. Tri-paranol, which inhibits the penultimate step in the pathway, was introduced into clinical use in the mid-1960s but was withdrawn from the... 

Despite the plethora of evidence provided by these trials and the publication of national guidelines (Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults 1993 Pyorala et al., 1994), many patients still go untreated, even those with CHD (Bowker et al., 1996 EUROASPIRE Study Group 1997 Pearson and Peters, 1997). Unfortunately, some practitioners are slow to change their clinical approach despite unequivocal results from clinical trials. 

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