Aggressive statin therapy and the risk of malignancy.

The advent of pharmacologic agents which partially inhibit the rate limiting enzyme in cholesterol synthesis (3-hydroxy-3-methylglutaryl Co-A reductase) provided a major advance in preventive medicine. Clinical trials in both primary and secondary prevention have demonstrated reduction in cardiovascular events by statin therapy. However, early epidemiologic studies proposed an inverse relationship between cholesterol levels and mortality.

Metabolic syndrome in South Asians.

Metabolic syndrome (MS) is a cluster of multiple cardio-metabolic risk factors in the same individual. People with MS are at high risk for the development of cardiovascular disease (CVD), chronic kidney disease (CKD), and cerebrovascular disease (CeVD). The excessive presence of MS in South Asians is likely responsible for significant morbidity in this population.

Type 2 diabetes and cardiovascular risk factors.

Diabetes is associated with higher cardiovascular morbidity and mortality. Hypertension, hyperlipidemia and diabetes are independently associated with increased risk of cardiovascular (CV) disease. Subjects with type 2 diabetes are at two- to four-fold increased risk of CV disease compared to those without diabetes.

Evolving concepts of the role of high-density lipoprotein in protection from atherosclerosis.

High-density lipoprotein (HDL) is classified as a negative risk factor due to the inverse relationship between elevated levels of HDL cholesterol and atherosclerosis. The mechanism by which HDL can mediate protection from atherosclerosis is complex and multifactorial. The primary role of reverse cholesterol transport in the reduction of risk for coronary artery disease is supported by a considerable amount of experimental data.

Statins as adjunctive therapy in the management of hypertension.

The effective optimization of the modifiable risk factors for the development of atherosclerosis is the cornerstone preventive cardiology. Risk factor clustering has been demonstrated to occur in a higher prevalence than would be expected by chance alone. The common cardiovascular risk factors frequently share metabolic pathways.

Dysfunctional high-density lipoprotein and atherosclerosis.

High-density lipoprotein (HDL) is well established as a negative risk factor for the development of atherosclerosis. Epidemiologic, pathologic, and experimental studies have demonstrated a role for HDL in protection from coronary artery disease. HDL has been demonstrated to reduce the risk from atherosclerosis by multiple pathophysiologic mechanisms.

The role of statin therapy in the management of cardiomyopathies.

The non-lipid-lowering or pleiotropic effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have been hypothesized to beneficially alter mechanisms involved in heart failure. Retrospective analyses of heart failure trials as well as small prospective trials with nonmortality clinical and surrogate end points appeared to confirm this presumption. However, two recently published, large, prospective randomized trials did not demonstrate any significant clinical benefit of statins in heart failure patients.

Nicotinic acid: a new look at an old drug.

Dyslipidemia is central to the process of atherosclerosis. Modification of the lipid profile by diet, exercise, or pharmacologic therapy has been demonstrated to reduce the risk from atherosclerosis in clinical studies in primary and secondary prevention. Nicotinic acid has been in clinical use for over 50 years.

Role of insulin signaling in maintaining energy homeostasis.

Objective: To examine the role that insulin signaling plays in modulating metabolic functions involving both peripheral and hypothalamic systems.

Methods: We review the literature regarding insulin signaling as it relates to energy homeostasis.

Results: Insulin signaling in the periphery is known to affect hepatic glucose production and glucose uptake in muscle and adipose tissue.

Adjunctive interventions in myocardial infarction: the role of statin therapy.

Statin therapy has reduced cardiovascular morbidity and mortality across the spectrum of atherosclerosis. The administration of statins has been demonstrated to be effective in primary and secondary prevention clinical trials evaluating patients with high and low risk-factor profiles. The presumed mechanism of benefit of hypolipidemic therapy in the prevention of atherosclerotic disease was a reduction in the deposition of atherogenic lipoproteins in vulnerable areas of the coronary vasculature.

Diabetic dyslipidemia and atherosclerosis: evidence from clinical trials.

Diabetes is a highly prevalent disease in the United States and is increasing in both incidence and prevalence. Atherosclerotic vascular disease is a major cause of morbidity and mortality in diabetic patients. Type 2 diabetes is characterized by insulin resistance and frequently co-exists with a variety of cardiovascular risk factors, including hypertension, obesity, dyslipidemia, and physical inactivity.

Diabetic dyslipidemia and atherosclerosis: evidence from clinical trials.

Diabetes is a highly prevalent disease in the United States and is increasing in both incidence and prevalence. Atherosclerotic vascular disease is a major cause of morbidity and mortality in diabetic patients. Type 2 diabetes is characterized by insulin resistance and frequently co-exists with a variety of cardiovascular risk factors, including hypertension, obesity, dyslipidemia, and physical inactivity.

Obesity and inflammation: a new look at an old problem.

Obesity is a highly prevalent disease with multiple implications for cardiovascular morbidity and mortality. The traditional view of obesity is that excessive adipose tissue represents a passive storage depot of excess energy. However, obesity has been demonstrated to be a highly active endocrine organ with multiple metabolic pathways that interact with classic cardiac risk factors.