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Hypercholesterolemia and atherosclerosis: present and future therapy including LDL-apheresis
B A Kottke1, A A Pineda, M T Case
1Cardiovascular Research Unit, Mayo Clinic, Rochester, Minnesota 55903.
Insights
Hypercholesterolemia, a cause of atherosclerosis and heart disease, can be treated by lowering LDL cholesterol. LDL-apheresis methods show promise for reducing LDL while maintaining HDL levels.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Atherosclerosis, driven by hypercholesterolemia, is a leading cause of death globally.
- Effective management of high cholesterol is crucial for preventing coronary heart disease.
Framework:
- This review examines the link between hypercholesterolemia and atherosclerosis.
- It surveys current treatment strategies, including diet, medication, surgery, and plasmapheresis.
Implementation:
- Focuses on LDL-apheresis as a key therapeutic approach.
- Details various LDL-apheresis techniques: immunoadsorption, chemical affinity, and double-membrane filtration.
Implications:
- Highlights the importance of reducing LDL while preserving HDL cholesterol.
- Suggests LDL-apheresis as a potentially ideal therapy for hypercholesterolemia management.
Abstract:
Atherosclerosis-induced coronary heart disease remains the major cause of death and disability in industrialized countries. Hypercholesterolemia is recognized as a causative factor in the development of atherosclerosis. While the lowering of cholesterol levels as a treatment goal has met with general agreement and acceptance, the preferred methods for doing so are still open to conjecture. This literature review discusses various factors in the hypercholesterolemia-atherosclerosis link and surveys a variety of treatment protocols including diet modification, drug therapy, surgical intervention, and plasmapheresis. Evidence is accumulating to prove that the ideal hypercholesterolemia therapy is one that reduces LDL levels while maintaining or increasing HDL levels. Because LDL-apheresis has this potential, this paper also reviews the various LDL-apheresis methods, including immunoadsorption, chemical affinity, and double-membrane filtration.