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Related Concept Videos

Lipid-Lowering Drugs: Statins and Miscellaneous Agents01:20

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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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Lipids are an essential component of a balanced human diet. Triglycerides, which make up the majority of dietary lipids, are found in both saturated fats—commonly present in meat, dairy products, and certain tropical plants like coconut, and hydrogenated oils such as margarine and baking shortenings (trans fats)—and unsaturated fats, which are abundant in seeds, nuts, olive oil, and most vegetable oils. The main sources of cholesterol include egg yolks, various meats and organ...
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LDL Cholesterol Uptake Assay Using Live Cell Imaging Analysis with Cell Health Monitoring
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Should an LDL-Cholesterol Target-Based Approach Be Readopted?

C Michael White1,2, Erin R Weeda3, Elaine Nguyen4

  • 11 University of Connecticut, Storrs, CT, USA.

The Annals of Pharmacotherapy
|September 17, 2017
PubMed
Summary

Current hyperlipidemic guidelines may need to re-establish low-density lipoprotein (LDL) targets. Pharmacists play a key role in achieving these LDL goals with statin therapy and adjunctive treatments like ezetimibe or PCSK9 inhibitors.

Keywords:
LDL cholesterolPCSK9 inhibitorsezetimibelipid guidelinesstatins

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Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • The 2013 AHA/ACC hyperlipidemic guideline de-emphasized LDL goals, favoring statin intensity based on risk.
  • Adjunctive therapies on top of statins showed limited benefit, influencing this shift.

Purpose of the Study:

  • To review clinical trials that influenced hyperlipidemic guideline evolution.
  • To discuss the utility of LDL targets and adjunctive therapies.
  • To summarize the pharmacist's role in achieving LDL goals.

Main Methods:

  • A MEDLINE search from 1980-2017 identified relevant studies and guidelines.
  • Included English-language studies and guidelines on LDL-lowering therapy.
  • Forward and backward citation tracking was employed.

Main Results:

  • Recent evidence supports a return to LDL goals, with ezetimibe and PCSK9 inhibitors potentially reducing cardiovascular events.
  • Some guidelines reflect this shift, though not the AHA/ACC.
  • Pharmacists have demonstrated a positive impact on LDL goal attainment in various settings.

Conclusions:

  • Statins remain primary therapy, but LDL targets are crucial.
  • For patients not at goal on maximally tolerated statins, ezetimibe and PCSK9 inhibitors may improve outcomes.
  • Pharmacists are essential in the evolving paradigm of LDL goal management.