Physical activity, body mass index, lipid lowering agents, and LDL cholesterol levels in secondary prevention of CHD

2002 ◽  
Vol 2 (4) ◽  
pp. 1-10
Author(s):  
Daniel König ◽  
H.M Müller ◽  
A Schmidt-trucksaess ◽  
Aloys Berg
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Secondary Prevention ◽  
Body Mass ◽  
Ldl Cholesterol ◽  
Lipid Lowering ◽  
Cholesterol Levels ◽  
Lipid Lowering Agents

Mineralocorticoid receptor p.I180V polymorphism: Association with body mass index and LDL-cholesterol levels

2009 ◽  
Vol 33 (7) ◽  
pp. 472-477 ◽  
Author(s):  
F. L. Fernandes-Rosa ◽  
A. C. Bueno ◽  
R. Molina de Souza ◽  
M. de Castro ◽  
J. Ernesto dos Santos ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Mineralocorticoid Receptor ◽  
Ldl Cholesterol ◽  
Cholesterol Levels

scholarly journals First Choice Lipid-Lowering Treatment of Hypercholesterolemias

2021 ◽  
Vol 3 (1) ◽  
pp. 01-05
Author(s):  
Tania Martinez
Keyword(s):  
Secondary Prevention ◽  
Ldl Cholesterol ◽  
Lipid Lowering ◽  
Drastic Reduction ◽  
First Line ◽  
Pcsk9 Inhibitors ◽  
Statin Intolerance ◽  
Cholesterol Levels ◽  
First Choice ◽  
Coa Reductase

Several recent studies with lipid-lowering substances have shown a significant reduction in complications of this disease with drastic reduction of LDL-cholesterol levels. However, a huge proportion of patients in secondary prevention remain with inefficient treatment. Vastatins, also called statins, are considered worldwide as the first-line pharmacotherapy for the treatment of hypercholesterolemia, being the most efficient drugs to lower LDL-cholesterol, still presenting excellent tolerability. The main mechanism of action of vastatins is inhibition of the enzyme hydroxymethylglutaril-coenzyme A (HMG-CoA) reductase. Currently, the therapeutic arsenal for cases of family hypercholesterolemia and statin intolerance incorporated PCSK9 inhibitors (proprotein convertase subtilisin/kexin type 9) which is an enzyme that is involved in the degradation of the LDL- cholesterol receptor in the lysosome, preventing its recycling to the cell surface, thus reducing the amount of LDL- cholesterol receptors available, with consequent elevation of this lipid. Mutations with gain of function that lead to an increase in the expression of this enzyme cause, therefore, an increase in LDL- cholesterol, while mutations that lead to a decrease in its expression decrease LDL-cholesterol.

scholarly journals Pharmacological Interventions to Treat Antipsychotic-Induced Dyslipidemia in Schizophrenia Patients: A Systematic Review and Meta Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Pruntha Kanagasundaram ◽  
Jiwon Lee ◽  
Femin Prasad ◽  
Kenya A. Costa-Dookhan ◽  
Laurie Hamel ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Controlled Trials ◽  
Pharmacological Interventions ◽  
Off Label ◽  
Cholesterol Levels ◽  
Lipid Lowering Agents ◽  
Lipid Parameters

Introduction: Antipsychotic-induced dyslipidemia represents a common adverse effect faced by patients with schizophrenia that increases risk for developing further metabolic complications and cardiovascular disease. Despite its burden, antipsychotic-induced dyslipidemia is often left untreated, and the effectiveness of pharmacological interventions for mitigating dyslipidemia has not been well-addressed. This review aims to assess the effectiveness of pharmacological interventions in alleviating dyslipidemia in patients with schizophrenia.Methods: Medline, PsychInfo, and EMBASE were searched for all relevant English articles from 1950 to November 2020. Randomized placebo-controlled trials were included. Differences in changes in triglycerides, HDL cholesterol, LDL cholesterol, and VLDL cholesterol levels between treatment and placebo groups were meta-analyzed as primary outcomes.Results: Our review identified 48 randomized controlled trials that comprised a total of 3,128 patients and investigated 29 pharmacological interventions. Overall, pharmacological interventions were effective in lowering LDL cholesterol, triglycerides, and total cholesterol levels while increasing the levels of HDL cholesterol. Within the intervention subgroups, approved lipid-lowering agents did not reduce lipid parameters other than total cholesterol level, while antipsychotic switching and antipsychotic add-on interventions improved multiple lipid parameters, including triglycerides, LDL cholesterol, HDL cholesterol, and total cholesterol. Off label lipid lowering agents improved triglycerides and total cholesterol levels, with statistically significant changes seen with metformin.Conclusion: Currently available lipid lowering agents may not work as well in patients with schizophrenia who are being treated with antipsychotics. Additionally, antipsychotic switching, antipsychotic add-ons, and certain off label interventions might be more effective in improving some but not all associated lipid parameters. Future studies should explore novel interventions for effectively managing antipsychotic-induced dyslipidemia.Registration: PROSPERO 2020 CRD42020219982; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020219982.

scholarly journals Improving statin treatment strategies to reduce LDL-cholesterol: factors associated with targets’ attainment in subjects with and without type 2 diabetes

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mario Luca Morieri ◽  
Valentina Perrone ◽  
Chiara Veronesi ◽  
Luca Degli Esposti ◽  
Margherita Andretta ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
High Intensity ◽  
Ldl Cholesterol ◽  
Treatment Strategies ◽  
Hdl Cholesterol ◽  
Statin Treatment ◽  
Lipid Lowering ◽  
Treatment Intensity ◽  
Cross Sectional ◽  
Cholesterol Levels

Abstract Background This cross-sectional study aimed to identify actionable factors to improve LDL-cholesterol target achievement and overcome underuse of lipid-lowering treatments in high- or very-high-cardiovascular risk patients. Methods We evaluated healthcare records of 934,332 subjects from North-Italy, including subjects with available lipid profile and being on statin treatments up to December 2018. A 6-month-period defined adherence with proportion-of-days-covered ≥ 80%. Treatment was classified as high-intensity-statin (HIS) + ezetimibe, HIS-alone, non-HIS (NHIS) + ezetimibe or NHIS alone. Results We included 27,374 subjects without and 10,459 with diabetes. Among these, 30% and 36% were on secondary prevention, respectively. Adherence was high (78–100%) and increased with treatment intensity and in secondary prevention. Treatment intensity increased in secondary prevention, but only 42% were on HIS. 2019-guidelines LDL-cholesterol targets were achieved in few patients and more often among those with diabetes (7.4% vs. 10.7%, p < 0.001). Patients in secondary prevention had mean LDL-cholesterol levels aligned slightly above 70 mg/dl (range between 68 and 73 mg/dl and between 73 and 85 mg/dl in patients with and without diabetes, respectively). Moreover, the differences in mean LDL-cholesterol levels observed across patients using treatments with well-stablished different LDL-lowering effect were null or much smaller than expected (HIS vs. NHIS from − 3 to − 11%, p < 0.001, HIS + ezetimibe vs. HIS—from − 4 to + 5% n.s.). These findings, given the observational design of the study, might suggest that a “treat to absolute LDL-cholesterol levels” approach (e.g., targeting LDLc of 70 mg/dl) was mainly used by physicians rather than an approach to also achieve the recommended 50% reduction in LDL-cholesterol levels. Our analyses suggested that female sex, younger age, higher HDL-c, and elevated triglycerides are those factors delaying prescription of statin treatments, both in patients with and without diabetes and in those on secondary prevention. Conclusions Among patients on statin treatment and high adherence, only a small proportion of patients achieved LDL-cholesterol targets. Late initiation of high-intensity treatments, particularly among those with misperceived low-risk (e.g., female subjects or those with high HDL-cholesterol), appears as pivotal factors needing to be modified to improve CVD prevention.

Enrolling Caregivers in Obesity Interventions to Improve Obesity-Related Outcomes in Children

2021 ◽  
pp. 019394592110370
Author(s):  
Hannah Bessette ◽  
MinKyoung Song ◽  
Karen S. Lyons ◽  
Sydnee Stoyles ◽  
Christopher S. Lee ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Weight Loss ◽  
Linear Regression ◽  
Body Mass ◽  
Sedentary Time ◽  
Vigorous Physical Activity ◽  
Weight Loss Program ◽  
Weight Loss Programs ◽  
Obesity Interventions

In this study, we assessed the influences of change in moderate-to-vigorous physical activity (MVPA)/sedentary time (ST) of caregivers participating in a commercial weight-loss program on their children’s change in MVPA/ST. Data from 29 caregivers and their children were collected over 8 weeks. We used multivariable linear regression to assess associations of changes in caregiver’s percent of time spent in MVPA/ST and changes in their child’s percent of time spent in MVPA/ST. For caregivers that decreased body mass index (BMI) over 8 weeks, changes in caregivers’ MVPA was strongly associated with the change in children’s MVPA (β = 2.61 [95% CI: 0.45, 4.77]) compared to caregivers who maintained/increased BMI (β = 0.24 [–2.16, 2.64]). Changes in caregivers’ ST was strongly associated with changes in children’s ST (β = 2.42 [1.02, 3.81]) compared to caregivers who maintained/increased BMI (β = 0.35 [–0.45, 1.14]). Findings reinforce encouraging caregivers to enroll in weight-loss programs for the benefit of their children as well as for themselves.

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