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Pharmacological intervention for altering lipid metabolism
1Department of Medicine, Bowman Gray School of Medicine, Winston-Salem, North Carolina.
Drugs
|January 1, 1990
Summary
Pharmacological interventions can lower atherogenic low-density lipoprotein (LDL) and raise high-density lipoprotein (HDL) cholesterol. These lipid-modifying drugs help prevent coronary heart disease (CHD) when non-drug methods fail.
Area of Science:
- Lipid metabolism and cardiovascular disease prevention.
Background:
- Pharmacological interventions for dyslipidemia aim to reduce atherogenesis and prevent coronary heart disease (CHD).
- Non-pharmacological methods like smoking cessation, weight reduction, and exercise are primary approaches.
- Understanding low-density lipoprotein (LDL) and high-density lipoprotein (HDL) metabolism is crucial for identifying drug targets.
Purpose of the Study:
- To provide an overview of lipoprotein metabolism.
- To identify sites for pharmacological intervention in lipoprotein pathways.
- To discuss drugs that alter LDL and HDL levels and their impact on CHD.
Main Methods:
- Review of pharmacological agents targeting LDL and HDL metabolism.
- Discussion of mechanisms of action for various lipid-lowering drugs.
- Analysis of clinical trial data on CHD incidence reduction.
Main Results:
- Hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitors and cation-exchange resins reduce LDL by increasing hepatic LDL receptor synthesis.
- Nicotinic acid and gemfibrozil inhibit very low-density lipoprotein (VLDL) secretion, indirectly lowering LDL.
- Gemfibrozil and cholestyramine stimulate apoprotein A1 synthesis, increasing HDL levels.
Conclusions:
- Reducing LDL cholesterol concentration is effective in decreasing CHD incidence.
- Raising HDL cholesterol levels may contribute to the clinical benefits of certain lipid-modifying drugs.
- Pharmacological strategies targeting lipoprotein metabolism offer a means to prevent cardiovascular disease.