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Titolo:
The clinical relevance and management of high-density lipoprotein deficiency
Autore:
Zlaket-Matta, G; Vela, BS; Brinton, EA;
Indirizzi:
Carl T Hayden VA Med Ctr, Sec Metab Endocrinol & Nuts, Phoenix, AZ 85012 USA Carl T Hayden VA Med Ctr Phoenix AZ USA 85012 Nuts, Phoenix, AZ 85012 USA
Titolo Testata:
ENDOCRINOLOGIST
fascicolo: 1, volume: 11, anno: 2001,
pagine: 16 - 25
SICI:
1051-2144(200101/02)11:1<16:TCRAMO>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; APOLIPOPROTEIN-A-I; MODERATE ALCOHOL-CONSUMPTION; FRACTIONAL CATABOLIC RATE; ISCHEMIC HEART-DISEASE; HDL CHOLESTEROL LEVELS; MIDDLE-AGED MEN; POSTMENOPAUSAL WOMEN; PLASMA-LIPIDS; SECONDARY PREVENTION;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
119
Recensione:
Indirizzi per estratti:
Indirizzo: Brinton, EA Carl T Hayden VA Med Ctr, Sec Metab Endocrinol & Nuts, 650 E Indian Sch Rd, Phoenix, AZ 85012 USA Carl T Hayden VA Med Ctr 650 E Indian Sch Rd Phoenix AZ USA 85012
Citazione:
G. Zlaket-Matta et al., "The clinical relevance and management of high-density lipoprotein deficiency", ENDOCRINOLO, 11(1), 2001, pp. 16-25

Abstract

High-density lipoprotein (HDL) is well known strongly to protect against atherosclerosis. Low HDL has not been an important target of medical treatment, however, largely due to a lack of convincing clinical trial data showing benefits of HDL raising therapy, Two recent breakthroughs in HDL researchare now changing our clinical perspective on treatment of HDL deficiency. First, basic studies have enhanced our understanding of HDL me tabolism andits anti-atherosclerotic mechanisms. Evidence is increasing for HDL's rolein reverse cholesterol transport, and for its antioxidant, pro endothelialand anti thrombotic effects. Second, clinical trials have better established benefits of treatment of HDL deficient patients, where statin and fibrate treatment have significantly reduced clinical cardiovascular events. Also, two pharma cologic agents useful for HDL raising have newly become available in the US, facilitating treatment of HDL deficiency. As a result, thresholds and goals for HDL raising are being increased from 35 to 40 mg/dL or higher. Treatment of low HDL begins with smoking cessation, regular physical activity, and weight reduction, as indicated. Drug therapy may then be indicated for HDL levels remaining below goal in cases of secondary prevention or high-risk primary prevention. Niacin is the most effective agent for HDL raising, and the new intermediate release Niaspan is easier to use than the traditional immediate release form, Fibrates and statins may be first line agents for HDL deficiency in cases with concurrent hypertriglyceridemiaor hyper cholesterolemia, respectively. Oral estrogen re placement raises HDL in postmenopausal women, but its use is controversial. Lifestyle and pharmacologic regimens for HDL raising are of increasing clinical importance for atheroprevention in high risk patients with HDL deficiency.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 17:30:03