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Titolo:
Treatment of mixed hyperlipidaemia using a combination of omega-3 fatty acids and HMG CoA reductase inhibitor
Autore:
Bhatnagar, D; Mackness, MI; Durrington, PN;
Indirizzi:
Royal Oldham Hosp, Oldham OL1 2JH, England Royal Oldham Hosp Oldham England OL1 2JH m Hosp, Oldham OL1 2JH, England Manchester Royal Infirm, Dept Med, Manchester M13 9WL, Lancs, England Manchester Royal Infirm Manchester Lancs England M13 9WL , Lancs, England
Titolo Testata:
EUROPEAN HEART JOURNAL SUPPLEMENTS
fascicolo: D, volume: 3, anno: 2001,
pagine: D53 - D58
SICI:
1520-765X(200106)3:D<D53:TOMHUA>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-DENSITY-LIPOPROTEIN; CORONARY-ARTERY DISEASE; FAMILIAL HYPERCHOLESTEROLEMIA HETEROZYGOTES; ISCHEMIC HEART-DISEASE; RISK-FACTORS; FISH-OIL; HYPERTRIGLYCERIDEMIC PATIENTS; CARDIOVASCULAR-DISEASE; PLASMA-LIPIDS; OMEGA-3-FATTY-ACIDS;
Keywords:
hyperlipidaemia; triglycerides; cholesterol; omega 3-fatty acids; statins;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
49
Recensione:
Indirizzi per estratti:
Indirizzo: Bhatnagar, D Royal Oldham Hosp, Rochdale Rd, Oldham OL1 2JH, England RoyalOldham Hosp Rochdale Rd Oldham England OL1 2JH England
Citazione:
D. Bhatnagar et al., "Treatment of mixed hyperlipidaemia using a combination of omega-3 fatty acids and HMG CoA reductase inhibitor", EUR H J SUP, 3(D), 2001, pp. D53-D58

Abstract

Serum triglycerides tend to be particularly strong predictors of coronary risk. A meta-analysis of 17 population-based prospective studies indicates that after adjustment for high-density lipoprotein (HDL) cholesterol, a 1 mmol.l(-1) increase in serum triglyceride level was associated with a 4% increase in risk in men and 37% in women. There is also evidence to indicate that serum triglyceride levels greater than 1-5 mmol.l(-1) are associated with the presence of the more atherogenic small and dense low-density lipoprotein (LDL) subfraction. Many patients who develop coronary heart disease (CHD) have both hypercholesterolaemia and hypertriglyceridaemia. When diet isimproved hypertriglyceridaemia up to 4 mmol.l(-1) is often corrected, so that many of these patients can be managed on a statin alone. In some patients, however, and particularly those with genetic disorders such as familialcombined hyperlipidaemia and the rarer remnant hyperlipidaemia (type III hyperlipoproteinaemia), the hyperlipidaemia responds poorly to lifestyle changes. In many patients with mixed hyperlipidaemia lipid-lowering monotherapy often produces improvement in serum cholesterol level, but not in serum triglyceride level or vice versa. One strategy is to use a combination of a statin and a fibrate in high-risk patients with mixed hyperlipidaemia. While effective, this combination increases the possibility of abnormal biochemical liver function tests and myalgia. Concentrated omega-3 fatty acids can lower serum triglyceride levels by upto 38% in a dose-dependent manner. Serum cholesterol levels usually remainunchanged, but there is a modest increase of about 6% in HDL cholesterol. We carried out a randomized double-blind, placebo-controlled trial using a parallel group design to examine the triglyceride-lowering effects of Omacor (R) in patients with established CHD and type IIb hyperlipidaemia who were already on simvastatin. Our results show that, in patients with CHD and moderate hypertriglyceridaemia who were receiving simvastatin in a dose similar to that seen in the Scandinavian Simvastatin Survival Study, concentrated omega-3 fatty acids administration was effective in lowering serum triglyceride levels.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 06:43:22