将LDL胆固醇降低到非常低的水平:在已知好处和潜在风险之间航行
Stefania Angela Di Fusco1,2, Massimo Volpe3,4, Federico Nardi5
1Clinical and Rehabilitation Cardiology Unit, Emergency Department, San Filippo Neri Hospital, ASL Rome 1, Rome, Italy. stefaniaa.difusco@aslroma1.it.
概括
达到非常低的低密度脂蛋白胆固醇 (LDL-C) 是有益的,癌症或神经退行性疾病的风险最小. 监测出血性中风风险的血压,并考虑使用新的药物,以避免与他类药物相关的糖尿病.
科学领域:
- 心血管医学 心血管医学
- 脂质学 脂质学是指脂质学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 越来越多的证据支持这种说法.
研究的目的:
- 审查非常低低密度脂蛋白胆固醇 (LDL-C) 水平的临床影响和潜在不良影响.
- 为了解决医生对极端LDL-C降低和治疗减缓的担忧.
- 为管理患有非常低的LDL-C的患者提供基于证据的指导.
主要方法:
- 关于胆固醇恒温的研究的文献综述.
- 对具有非常低LDL-C的基因决定模型的分析.
- 对降脂药物和不良事件的临床试验数据的检查.
主要成果:
- 人体表现出胆固醇的自给自足,维持细胞功能在非常低的LDL-C水平.
- 没有发现非常低的LDL-C增加癌症或神经退行性疾病的风险;观察到潜在的益处.
- 潜在的出血性中风风险增加需要血压监测.
- 类固醇药物治疗与剂量依赖的新发糖尿病风险有关,这种风险在较新的降脂药物中没有观察到.
结论:
- 非常低的LDL-C水平通常是安全的,并且可以通过现代降脂疗法实现.
- 仔细的患者管理,包括血压控制和考虑药物选择,至关重要.
- 医生应该平衡降低LDL-C的好处与潜在风险,避免治疗不足.
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