scholarly journals Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare Utilization

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 723
Author(s):  
Sara Malo ◽  
María José Rabanaque ◽  
Lina Maldonado ◽  
Belén Moreno-Franco ◽  
Armando Chaure-Pardos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mediterranean Diet ◽  
Healthcare Utilization ◽  
Drug Users ◽  
Healthy Lifestyle ◽  
Lipid Lowering ◽  
Health Study ◽  
Lipid Lowering Therapy ◽  
Lipid Lowering Drug ◽  
Lowering Drug

We sought to identify specific profiles of new lipid-lowering drug users based on adherence to a healthy lifestyle and persistence with medication, and to characterize co-morbidities, co-treatments, and healthcare utilization for each of the profiles identified. Observational study in 517 participants in the Aragon Workers’ Health Study (AWHS) without previous cardiovascular disease (CVD) and who initiated lipid-lowering therapy. Data were collected from workplace medical examinations and administrative health databases (2010–2018). Using cluster analysis, we identified distinct patient profiles based on persistence with therapy and lifestyle. We then compared characteristics, morbidity, and healthcare utilization across clusters. Participants were aggregated into four clusters based on persistence with therapy, smoking status, adherence to Mediterranean diet, and physical activity. In cluster 1 (n = 113), comprising those with a healthiest lifestyle (14.2% smokers, 84.0% with medium-high adherence to Mediterranean diet, high physical activity), 16.8% were persistent. In cluster 3 (n = 108), comprising patients with the least healthy lifestyle (100% smokers, poor adherence to the Mediterranean diet, low level of physical activity), all were non-persistent. Clusters 2 (n = 150) and 4 (n = 146) both comprised patients with intermediate lifestyle behaviors, but differed in terms of persistence (100 and 0%, respectively). Compared with other clusters, the burden of morbidity, cardiovascular score, and healthcare utilization were lower in cluster 1. The healthy adherer effect was only observed in new lipid-lowering drug users of certain profiles. Furthermore, we found that differences in adherence to lifestyle and medication recommendations for CVD prevention influenced morbidity burden and healthcare utilization.

The role of bempedoic acid in the management of dyslipidaemia

2021 ◽  
Vol 3 (12) ◽  
pp. 484-488
Author(s):  
Beverley Bostock
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Technology Appraisal ◽  
The United Kingdom ◽  
Lipid Lowering Drug ◽  
Lowering Therapy ◽  
Lowering Drug

Bempedoic acid is a new oral lipid-lowering therapy which has been licenced for use in the United Kingdom. It can be used alone, with a statin, or with other lipid-lowering therapies where the target level for low density lipoprotein has not been achieved with these therapies alone. Bempedoic acid with ezetimibe can be prescribed for people who are unable to tolerate statins. This combination has received NICE approval following a technology appraisal. This paper discusses the place for of bempedoic acid as a lipid lowering drug and consider the mode of action, licensed indications, adverse drug reactions and the NICE technology appraisal recommendations.

Effect of Lipid-Lowering Drug Therapy on Small-Dense Low-Density Lipoprotein

2005 ◽  
Vol 39 (3) ◽  
pp. 523-526 ◽  
Author(s):  
James M Backes ◽  
Cheryl A Gibson
Keyword(s):  
Drug Therapy ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Low Density ◽  
Search Terms ◽  
Lipid Lowering Drug ◽  
Mixed Dyslipidemia ◽  
Lowering Drug

OBJECTIVE: To review the effects of lipid-lowering therapy on small-dense low-density lipoprotein cholesterol (sdLDL-C). DATA SOURCES: Literature was obtained from MEDLINE (1989–September 2004) and references of selected articles. Key search terms included small-dense LDL-C and lipid-lowering drug therapy. DATA SYNTHESIS: Statins, fibrates, and niacin have demonstrated favorable effects on sdLDL-C, especially among patients with mixed dyslipidemia or hypertriglyceridemia. These effects include a reduction of sdLDL-C and/or a shift to the larger, less atherogenic LDL-C. CONCLUSIONS: Data suggest that statins, fibrates, and niacin are effective at reducing concentrations of sdLDL-C and possibly normalizing LDL-C subclasses.

Prior TIA, lipid-lowering drug use, and physical activity decrease ischemic stroke severity

Neurology ◽  
2006 ◽  
Vol 67 (8) ◽  
pp. 1403-1410 ◽  
Author(s):  
D. Deplanque ◽  
I. Masse ◽  
C. Lefebvre ◽  
C. Libersa ◽  
D. Leys ◽  
...  
Keyword(s):  
Physical Activity ◽  
Ischemic Stroke ◽  
Drug Use ◽  
Lipid Lowering ◽  
Stroke Severity ◽  
Lipid Lowering Drug ◽  
Lowering Drug ◽  
Activity Decrease

Umbrella Review on Non-Statin Lipid-Lowering Therapy

2021 ◽  
pp. 107424842110029
Author(s):  
Semira Abdi Beshir ◽  
Nadia Hussain ◽  
Asim Ahmed Elnor ◽  
Amira S. A. Said
Keyword(s):  
Unmet Need ◽  
Lipid Lowering ◽  
Current Evidence ◽  
Atherosclerotic Cardiovascular Disease ◽  
Lipid Lowering Therapy ◽  
Pcsk9 Inhibitors ◽  
Icosapent Ethyl ◽  
Lipid Lowering Drug ◽  
Increased Risk ◽  
Lowering Drug

Dyslipidemia, particularly increased low-density lipoprotein cholesterol (LDL-C) levels, are associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD) events. There is an unmet need for ASCVD risk reduction even with the optimal use of statin therapy, which has led to an ongoing search for novel targets for cholesterol reduction to decrease ASCVD events. Objectives: The main aim of this review was to summarize current evidence on approved and emerging non-statin lipid-lowering therapies. Methods and Materials: Recent literature on U.S. FDA approved non-statin lipid-lowering therapies and evolving lipid-lowering drugs currently under development was reviewed. Results and Discussion: In the past 20 years, the emergence of non-statin cholesterol-lowering drugs has changed the landscape of dyslipidemia management. Food and Drug Administration approval of non-statin lipid-lowering therapies such as ezetimibe, proprotein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors (evolocumab, alirocumab), bempedoic acid and combination of bempedoic acid and ezetimibe, evinacumab and other triglyceride-lowering agents (eg, icosapent ethyl) has emerged. The European Commission has also recently approved inclisiran for treatment of hypercholesterolemia and mixed hypercholesterolemia even though FDA has put the approval of this drug on hold. Recent guidelines have incorporated PCSK9 inhibitors to treat patients with primary hyperlipidemia and patients with very high-risk ASCVD, who could not achieve adequate lipid-lowering with combination therapy of maximally tolerated statin and ezetimibe. Icosapent ethyl use as an adjunct therapy to statins is also recommended to reduce the risk of ASCVD in patients with hypertriglyceridemia. Conclusion: Despite cost limitations, the uptake of PCSK9 inhibitors is increasing. Approval of bempedoic acid alone or in combination with ezetimibe has provided additional oral lipid-lowering drug alternatives to ezetimibe. Various lipid-lowering drug targets are under investigation.

Abstract P195: Combination Therapy not the Intensity of Statin Therapy Improves LDL Goal Attainment in Clinical Practice

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Brett Victor ◽  
Lilian Ahedor ◽  
Longjian Liu ◽  
Dean G Karalis
Keyword(s):  
Clinical Practice ◽  
Combination Therapy ◽  
Statin Therapy ◽  
Goal Attainment ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
High Potency ◽  
Lipid Lowering Drug ◽  
Lowering Drug ◽  
The Impact

Background: In clinical practice most coronary heart disease (CHD) patients (pts) are not achieving their recommend LDL goal of < 70 mg/dL. We assessed the impact of statin dose and combination therapy in achieving optimal LDL levels in CHD pts. Methods: We conducted a retrospective analysis of outpatient electronic health records (EHR) from a large cardiology practice from September 2008 to September 2009. The most recent lipid profile, lipid-lowering medications and doses were extracted from the EHR. Statin potency was assessed based on the brand and dose of statin. Results: We identified 9,950 CHD pts; 59% were on a statin alone (SA), 27% on a statin + another lipid-lowering drug, 4% on no statin but on another lipid-lowering drug and 10% were on no lipid-lowering drugs. Only 37% of SA pts achieved an LDL < 70 mg/dL, but did so more often than pts on no statin but on another lipid-lowering drug (37 vs. 18%; p < 0.0001). Among SA pts, 70% were on moderate to high potency statins. The intensity of statin therapy did not improve LDL goal attainment. Among pts on combination therapy, 41% on statin + ezetimibe (S+E) and 46% on statin + niacin (S+N) achieved an LDL < 70 mg/dL (p = 0.01 and < 0.0001 vs. SA). Only 14% of pts were on S+E and 9% on S+N. Statin plus fibrate did not improve LDL goal attainment compared to SA (35 vs. 37%; p = 0.23). Few pts were taking bile acid sequestrants (< 0.5%). If pts were switched to a high potency statin LDL goal attainment of < 70 mg/dL would increase to 46% and would increase further to 65% with combination therapy. Conclusions: Most CHD pts in clinical practice do not attain an LDL < 70 mg/dL, even among pts on high potency statins. The number of CHD pts on no statin is high. The combination of statin plus either ezetimibe or niacin is the most effective regimen to achieve an LDL < 70 mg/dL; however these drug combinations are used infrequently in clinical practice. Combination lipid-lowering therapy is needed to improve LDL goal attainment in CHD pts.

Prior TIA, lipid-lowering drug use, and physical activity decrease ischemic stroke severity

Neurology ◽  
2007 ◽  
Vol 68 (14) ◽  
pp. 1162-1163 ◽  
Author(s):  
M. Gotkine ◽  
I. Steiner ◽  
D . Deplanque ◽  
I . Masse ◽  
C . Lefebvre ◽  
...  
Keyword(s):  
Physical Activity ◽  
Ischemic Stroke ◽  
Drug Use ◽  
Lipid Lowering ◽  
Stroke Severity ◽  
Lipid Lowering Drug ◽  
Lowering Drug ◽  
Activity Decrease

Berberine: A Promising Natural Isoquinoline Alkaloid for the Development of Hypolipidemic Drugs

2020 ◽  
Vol 20 (28) ◽  
pp. 2634-2647
Author(s):  
Dong-Dong Li ◽  
Pan Yu ◽  
Wei Xiao ◽  
Zhen-Zhong Wang ◽  
Lin-Guo Zhao
Keyword(s):  
Clinical Trials ◽  
Animal Models ◽  
Physicochemical Properties ◽  
Isoquinoline Alkaloid ◽  
Hypolipidemic Activity ◽  
Lipid Lowering ◽  
Lipid Lowering Drug ◽  
Lipid Lowering Agent ◽  
Lowering Drug ◽  
Hypolipidemic Drugs

: Berberine, as a representative isoquinoline alkaloid, exhibits significant hypolipidemic activity in both animal models and clinical trials. Recently, a large number of studies on the lipid-lowering mechanism of berberine and studies for improving its hypolipidemic activity have been reported, but for the most part, they have been either incomplete or not comprehensive. In addition, there have been a few specific reviews on the lipid-reducing effect of berberine. In this paper, the physicochemical properties, the lipid-lowering mechanism, and studies of the modification of berberine all are discussed to promote the development of berberine as a lipid-lowering agent. Subsequently, this paper provides some insights into the deficiencies of berberine in the study of lipid-lowering drug, and based on the situation, some proposals are put forward.

scholarly journals AB0875-HPR NON-PHARMACOLOGICAL AND PHARMACOLOGICAL APPROACHES TO THE MANAGEMENT OF PATIENTS WITH OSTEOARTHRITIS AND LIPID METABOLISM DISORDERS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1461.1-1461
Author(s):  
T. Rogatkina ◽  
O. Korolik ◽  
V. Polyakov ◽  
G. Kravtsov ◽  
Y. Polyakova
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Lipid Metabolism ◽  
Lipid Profile ◽  
Fat Mass ◽  
Prognostic Significance ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lipid Metabolism Disorders ◽  
Group I

Background:Attention is drawn to the frequent combination of osteoarthritis (OA) with cardiovascular disease. Non-specific inflammation plays a significant role in the pathogenesis of OA and atherosclerosis. Limiting the physical activity of patients with OA is an additional important factor aggravating the course of cardiovascular disease (CVD). Chronic pain syndrome, causing a neuroendocrine response, is often the cause of the development of complications of atherosclerotic disease. Dyslipidemia is the main cause of atherosclerosis and vascular thrombosis.Objectives:To study variants of lipid metabolism disorders in female and male patients of different age groups with osteoarthritis.Methods:Case histories of 90 patients with OA were analyzed. The average age of patients was 63.27 ± 11.31 years. The average body mass index (BMI) is 39.8 ± 3.2. All patients underwent questionnaires, general clinical and biochemical blood tests with lipid profile determination, anthropometry, bioimpedansometry, and the main metabolic rate assessment using indirect calorimetry in dynamics (at the beginning of the study and after 3 months).Results:Burdened heredity for obesity, arterial hypertension (AH), diabetes mellitus (DM) was revealed. AH was diagnosed in 76 patients (84.4%), type II diabetes in 17 (18.9%), dyslipidemia and hypercholesterolemia in 56 (62.2%). Statins were taken by 43 patients (47.8%) - group I patients, which is associated with low adherence to therapy, group II included patients who did not initially take statins or stopped taking them at least 6 months before inclusion in the study.Against the background of diet therapy and physiotherapy exercises, BMI (R0.99; p <0.05), fat mass (R0.95; p <0.05) significantly decreased, lipid profile normalization was noted: total cholesterol (R0.66; p <0 .05), LDL (R0.69; p <0.05), HDL (R0.95; p <0.05), TG (R0.57; p <0.05), AST decreased (R0.64; p <0.05) and ALT (R0.76; p <0.05) in both groups of patients, regardless of lipid-lowering therapy. A decrease in fat mass correlated with TG levels (R0.51; p <0.05), an increase in skeletal muscle mass (R0.60; p <0.05), lean mass (R0.72; p <0.05), and active cell mass (R0.59; p <0.05). The lipid profile in the I group of patients was significantly better before and at the end of the study. Long-term effects have not been investigated due to the short duration of the study.Conclusion:In patients with OA, a high frequency of concomitant diseases of the cardiovascular system, lipid metabolism disorders was found. Non-drug therapy has a positive effect on the lipid profile and the level of transaminases. The decrease in body weight due to loss of fat mass reliably correlates with the level of TG. Timely use of statins contributes to the normalization of the lipid profile, reduces the risk of cardiovascular disease in patients with OA. It is necessary to study lipid profile disorders in patients with OA with recommendations for lifestyle modification (diet, physical activity), and if necessary, prescribe lipid-correcting therapy.References:[1]E. Simakova, B. Zavodovsky, L. Sivordova [et al]. Prognostic significance of lipid disorders markers determination in pathogenesis of osteoarthritis. Vestnik Rossijskoj voenno-medicinskoj akademii. 2013. No. 2 (42). P.29-32.[2]Zavodovsky B.V., Sivordova L.E. Prognostic significance value of definition of leptin level determination in osteoarthritis. Siberian Medical Journal (Irkutsk). 2012; 115(8):069-072.Disclosure of Interests:None declared

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