Lipid-lowering therapy and the patient with multiple risk factors: what have we learned from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT)?

2005 ◽  
Vol 118 (12) ◽  
pp. 3-9 ◽  
Author(s):  
Peter S. Sever
Keyword(s):  
Risk Factors ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Multiple Risk Factors ◽  
Cardiac Outcomes ◽  
Lowering Therapy ◽  
Multiple Risk

scholarly journals Cardiovascular risk factors and COVID-19 outcomes in hospitalised patients: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045482
Author(s):  
Didier Collard ◽  
Nick S Nurmohamed ◽  
Yannick Kaiser ◽  
Laurens F Reeskamp ◽  
Tom Dormans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Icu Admission ◽  
Lowering Therapy ◽  
Secondary Outcomes ◽  
Age And Sex

ObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.DesignWe analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95% CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91).ConclusionsThe accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.

Coronary artery disease

2012 ◽  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antihypertensive Drugs ◽  
Lipid Lowering ◽  
Atherosclerotic Plaques ◽  
Lipid Lowering Therapy ◽  
Lipid Management ◽  
Lowering Therapy ◽  
Artery Disease

Atherosclerosis: pathophysiology 212Development of atherosclerotic plaques 214Epidemiology 216Assessment of atherosclerotic risk 218Risk factors for coronary artery disease 220Hypertension 226Treatment of high blood pressure 228Combining antihypertensive drugs 230Lipid management in atherosclerosis 232Lipid-lowering therapy 236When to treat lipids ...

scholarly journals Inclisirán as an alternative treatment for Hypercholesterolemia

2021 ◽  
Vol 12 (3) ◽  
pp. 517-521
Author(s):  
Jorge Andrés Ojeda Villota ◽  
Javier Alfredo Pérez Martínez ◽  
Luis Alberto Burgos de Moya ◽  
Rodrigo Alfonso Chavez Vega ◽  
Roxana Rivera Valencia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Low Density ◽  
Pcsk9 Inhibitors ◽  
Cholesterol Levels ◽  
Lowering Therapy

Hypercholesterolemia (CH) is defined as the elevation of serum cholesterol levels, especially low-density lipoprotein (LDL) cholesterol, which is considered to be one of the most relevant risk factors for triggering cardiovascular disease, for This is vitally important to start treatment, there are several highly useful pharmacological groups for lipid-lowering therapy, among them we highlight the PCSK9 inhibitors, among the molecules that are part of this group we find inclisirán, this being a structure that promises a lot in regarding the management of hypercholesterolemia.

scholarly journals Residual Risk of Cardiovascular Complications in Case of Adequate Lipid-Lowering Therapy

2018 ◽  
Vol 3 (2) ◽  
pp. 19-25
Author(s):  
VV V Simerzin ◽  
OV V Fatenkov ◽  
IV V Gagloeva ◽  
MA A Galkina ◽  
YaA A Panisheva
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Cardiovascular Complications ◽  
Residual Risk ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Target Level ◽  
Lowering Therapy ◽  
Risk Patients ◽  
Very High

This article is devoted to the problems of residual risk of cardiovascu1ar comp1ications deve1opment for high and very high risk patients under adequate lipid-fowering pharmacotherapy in spite of c^lestera! and tow-density 1ipoproteins target level achievement. Afong with classic risk factors the special atte^ton is given to 1ipoprotein (a) [LP (a)] as the most aggressive factor of cardwvascular system atherosclerotic diseases devetopment and their comp1ications. Great importance is attached to 1ipidopheresis.

scholarly journals Statin-associated muscle symptoms: epidemiology, risk factors, mechanisms and treatment

Kardiologiia ◽  
2019 ◽  
Vol 59 (5S) ◽  
pp. 4-12
Author(s):  
A. I. Dyadyk ◽  
T. E. Kugler ◽  
S. R. Zborowskyy ◽  
Yu. V. Suliman
Keyword(s):  
Risk Factors ◽  
Clinical Manifestations ◽  
Statin Treatment ◽  
Lipid Lowering ◽  
Clinical Aspects ◽  
Lipid Lowering Therapy ◽  
Treatment And Prevention ◽  
Lowering Therapy ◽  
Atherosclerotic Cardiovascular Diseases ◽  
Alternative Lipid

Statins are widely prescribed and the risk of adverse drug reactions of lipid-lowering therapy is actively discussed, including muscle symptoms. This review synthesizes the knowledge about the clinical aspects of statin-associated muscle symptoms, which is important for the practitioner. Potential mechanisms of their development, risk factors, clinical manifestations, treatment and prevention are described. Timely detection the side effects of statins makes it possible to diagnose and eliminate, which is crucial for conducting lipid-lowering therapy for patients with atherosclerotic cardiovascular diseases. Management of statin-associated muscle symptoms requires altering (reduced dosages, use of another statin or alternative lipid-lowering drugs) or discontinuing the statin treatment. 

scholarly journals Assessment of Common Risk Factors and Lifestyle Habits Associated with Atherogenic Risk and Lipid-Lowering Therapy in Men with Type 2 Diabetes

2019 ◽  
Vol 26 (4) ◽  
pp. 425-434
Author(s):  
Zakia Hadj-Benali ◽  
Mustapha Diaf ◽  
Méghit Boumediene Khaled
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lifestyle Habits ◽  
Adult Men ◽  
Lipid Ratios ◽  
Lowering Therapy ◽  
Common Risk Factors

Abstract Background and aims: Our objective was to determine common risk factors and lifestyle habits associated with atherogenic risk and with the use of lipid-lowering therapy in men with type 2 diabetes. Material and Methods: A comparative cross-sectional study was performed in the northwestern Algeria during eleven months on adult men patients with type 2 diabetes. Anthropometric parameters, blood pressures and lipid profile were evaluated. Data of common risk factors and lifestyle habits associated to atherosclerosis were compared between two groups according to the lipid lowering therapy use based on statins. Results: 147 adult men patients with type 2 diabetes were involved in the study, 68 (46.26%) were under statins therapy and 79 (53.74%) were not. Significant associations with statins use were observed regarding the age group of 61-70 years (OR: 0.156 [0.043-0.570]; p=0.005), a salary of less than 30000 Algerian dinars (≈250.60$) (OR: 5.758 [1.299-25.512]; p=0.021), age of diabetes of 2-3 years (OR: 0.105 [0.013-0.867]; p=0.036) as well as with lipid ratios and body mass index (BMI). However, no significant associations were noted regarding the other studied parameters (marital status, educational level, occupation, salary, and family history, smoking status, alcohol consumption and sports practices) with lipid lowering therapy. Conclusion: Age of patients, diabetes duration, lipid ratios and the low income of patients are the strongest factors associated with the use of lipid lowering therapy (statins). However, largest longitudinal studies are needed to determine whether modifiable lifestyle habits could influence the lipid lowering therapies prescription in diabetic patients over time.

scholarly journals Hypercholesterolaemia and vascular dementia

2017 ◽  
Vol 131 (14) ◽  
pp. 1561-1578 ◽  
Author(s):  
Jason P. Appleton ◽  
Polly Scutt ◽  
Nikola Sprigg ◽  
Philip M. Bath
Keyword(s):  
Risk Factors ◽  
Vascular Dementia ◽  
Clinical Decision Making ◽  
Developed Countries ◽  
Vascular Risk Factors ◽  
Lipid Lowering ◽  
Future Research ◽  
Lipid Lowering Therapy ◽  
Vascular Risk ◽  
Lowering Therapy

Vascular dementia (VaD) is the second commonest cause of dementia. Stroke is the leading cause of disability in adults in developed countries, the second major cause of dementia and the third commonest cause of death. Traditional vascular risk factors–diabetes, hypercholesterolaemia, hypertension and smoking–are implicated as risk factors for VaD. The associations between cholesterol and small vessel disease (SVD), stroke, cognitive impairment and subsequent dementia are complex and as yet not fully understood. Similarly, the effects of lipids and lipid-lowering therapy on preventing or treating dementia remain unclear; the few trials that have assessed lipid-lowering therapy for preventing (two trials) or treating (four trials) dementia found no evidence to support the use of lipid-lowering therapy for these indications. It is appropriate to treat those patients with vascular risk factors that meet criteria for lipid-lowering therapy for the primary and secondary prevention of cardiovascular and cerebrovascular events, and in line with current guidelines. Managing the individual patient in a holistic manner according to his or her own vascular risk profile is recommended. Although the paucity of randomized controlled evidence makes for challenging clinical decision making, it provides multiple opportunities for on-going and future research, as discussed here.

scholarly journals Cardiovascular risk factors are independently associated with COVID-19 mortality: a prospective cohort study

2020 ◽  
Author(s):  
Didier Collard ◽  
Nick S. Nurmohamed ◽  
Yannick Kaiser ◽  
Laurens F. Reeskamp ◽  
Tom Dormans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Lowering Therapy ◽  
High Prevalence ◽  
Secondary Outcomes ◽  
Age And Sex

AbstractObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidemia, diabetes, and COVID-19 outcomes.DesignWe analyzed data from the prospective Dutch COVID-PREDICT cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from 8 participating hospitals, including two university hospitals from the COVID-PREDICT cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 polymerase chain reaction (PCR) or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during hospitalization. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid lowering therapy, and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of ICU-admission and ICU-mortality. Kaplan-Meier and Cox-regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid lowering therapy, and antidiabetics were used by 45%, 34.7%, and 22.1% of patients. After adjustment for age and sex, the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95%CI 1.15-2.02), but not with ICU-admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of respectively 2.09 (95%CI 1.55-2.80) and 1.46 (95%CI 1.11-1.91).ConclusionsThe accumulation of hypertension, dyslipidemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalized COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.Strengths and limitations of this studyWhile previous data reported a high prevalence of CVD risk factors in COVID-19 patients, this study investigated whether diabetes, dyslipidemia and hypertension predict adverse outcomes.This study is limited by the use of medication as surrogate for cardiovascular risk factorsThe causality of the investigated risk factors remains to be addressed in future studies.

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