Reducing High Blood Cholesterol Levels With Drugs

JAMA ◽  
1991 ◽  
Vol 265 (15) ◽  
pp. 1950
Author(s):  
Perry A. Lambird
PEDIATRICS ◽  
1992 ◽  
Vol 89 (3) ◽  
pp. 545-554

The individualized approach to cholesterol lowering among children and adolescents focuses on those who appear to be destined to become adults with high blood cholesterol and an increased risk of coronary heart disease (CHD). This approach calls for the cooperative effort of the entire health professional team to identify, treat, and monitor individual children and adolescents who have high serum cholesterol levels, with the ultimate objective of preventing formation of atherosclerotic lesions in the coronary arteries. Because tracking of cholesterol levels from childhood to adulthood occurs but is imperfect, the panel sought ways to identify those children and adolescents whose elevated cholesterol levels are likely to indicate significant risk. The panel reached consensus that a low density lipoprotein (LDL)-cholesterol value of 130 mg/dL or higher (95th percentile), when associated with family history of cardiovascular disease (CVD) or parental hypercholesterolemia, is sufficiently elevated to warrant further evaluation and probable treatment and followup. The panel deliberately targeted the family unit and the familial aggregation of CVD and/or inherited lipid problems because hypercholesterolemia in a child from such a family is of clinical significance. Children with parents and grandparents who have premature CVD often have high cholesterol levels. Thus cholesterol levels in a child are linked to familial CVD.65,67,69,158 CHOLESTEROL MEASUREMENT: RECOMMENDATIONS FOR SELECTIVE SCREENING Who Should Have Cholesterol Measurements? The panel makes the following recommendations for the detection (selective screening), in the context of continuing health care, of children and adolescents likely to become adults with high blood cholesterol levels and increased risk for CVD.


2020 ◽  
Vol 21 (11) ◽  
pp. 3744
Author(s):  
Márton R. Szabó ◽  
Renáta Gáspár ◽  
Márton Pipicz ◽  
Nóra Zsindely ◽  
Petra Diószegi ◽  
...  

Ischemic preconditioning (IPre) reduces ischemia/reperfusion (I/R) injury in the heart. The non-coding microRNA miR-125b-1-3p has been demonstrated to play a role in the mechanism of IPre. Hypercholesterolemia is known to attenuate the cardioprotective effect of preconditioning; nevertheless, the exact underlying mechanisms are not clear. Here we investigated, whether hypercholesterolemia influences the induction of miR-125b-1-3p by IPre. Male Wistar rats were fed with a rodent chow supplemented with 2% cholesterol and 0.25% sodium-cholate hydrate for 8 weeks to induce high blood cholesterol levels. The hearts of normo- and hypercholesterolemic animals were then isolated and perfused according to Langendorff, and were subjected to 35 min global ischemia and 120 min reperfusion with or without IPre (3 × 5 min I/R cycles applied before index ischemia). IPre significantly reduced infarct size in the hearts of normocholesterolemic rats; however, IPre was ineffective in the hearts of hypercholesterolemic animals. Similarly, miR-125b-1-3p was upregulated by IPre in hearts of normocholesterolemic rats, while in the hearts of hypercholesterolemic animals IPre failed to increase miR-125b-1-3p significantly. Phosphorylation of cardiac Akt, ERK, and STAT3 was not significantly different in any of the groups at the end of reperfusion. Based on these results we propose here that hypercholesterolemia attenuates the upregulation of miR-125b-1-3p by IPre, which seems to be associated with the loss of cardioprotection.


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