Background: The aim of the study was to analyze the effectiveness of lipid-lowering therapy and therapeutic decisions made by physicians for patients not achieving LDL targets.
Methods: 11,768 patients undergoing therapy with statins for secondary prevention of atherosclerosis participated in a two-visit survey. In subjects not achieving the LDL-target (< 100 mg/dl), further therapeutic decisions made by physicians were recorded.
Results: Initially the LDL-target was achieved by 7.8% of patients on simvastatin and by 18.0% on atorvastatin, of which 20.8% were treated with at least a 40 mg dose. The most common changes in therapy to improve effectiveness was substituting simvastatin for another statin (75.2%, usually atorvastatin), or increasing atorvastatin dosage (59.8%). Intensification of a low fat diet and weight reduction were more frequently recommended in treatment with atorvastatin than with simvastatin (59.8% vs. 55.9%, p < 0.001). After enhanced therapy, the LDL-target was achieved by 27.8% on simvastatin and by 35.0% on atorvastatin (p < 0.001). In those with LDL levels remaining above the target, substitution of simvastatin with atorvastatin (49.9%), or the increase of atorvastatin dose (41.4%) was recommended. As previously, life-style counseling was more frequent in patients on atorvastatin (66.1% vs. 45.7% p < 0.001).
Conclusions: 1. The use of low dose statins and noncompliance with behavioral modification guidelines are responsible for the low levels of effectiveness found with lipid-lowering therapies. 2. Physicians prefer substitution of less effective statins over the increase of dose in patients not achieving LDL targets. 3. Life-style changes are under-prescribed by physicians and under-implemented by their patients.
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http://dx.doi.org/10.1016/s1734-1140(12)70778-8 | DOI Listing |
Heliyon
January 2025
Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213000, China.
Objective: Observational studies suggest that blood lipids are a risk factor for uterine fibroids (UFs) and that lipid-lowering drugs are beneficial for the treatment and prevention of UF; however, the conclusions are inconsistent. We aimed to determine the causal effects of lipids and lipid-lowering drugs on UFs using Mendelian randomization (MR).
Methods: Genetic variants from genome-wide association studies (GWAS) of lipid traits and variants in genes encoding lipid-lowering drug targets were extracted, and two independent UF GWAS were set as the outcome.
J Ethnopharmacol
January 2025
Third-grade Pharmacological Laboratory on Traditional Chinese Medicine, State Administration of Traditional Chinese Medicine, China Three Gorges University, Yichang 443002, China; College of Basic Medical Science, China Three Gorges University, Yichang 443002, China. Electronic address:
Ethnopharmacological Relevance: Panax japonicus (T. Nees) C.A.
View Article and Find Full Text PDFInt J Endocrinol Metab
July 2024
Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Context: Metabolic disorders are a growing global concern, especially in developed countries, due to their increasing prevalence. Serum lipid profiles, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), are commonly used clinical biomarkers for monitoring the progression of these metabolic abnormalities. In recent decades, hydrogen-rich water (HRW) has gained attention as a safe and effective treatment, with regulatory effects on lipid peroxidation and inflammatory responses in clinical trials.
View Article and Find Full Text PDFInt J Pharm
January 2025
School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515 China; Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515 China; Guangdong Basic Research Center of Excellence for Integrated Traditional and Western Medicine for Qingzhi Diseases, Guangzhou 510515 China. Electronic address:
Atherosclerosis, a major cause of cardiovascular diseases, involves complex pathophysiological processes. The co-delivery of multiple bioactive components derived from phytomedicine to atherosclerotic plaque is challenging, especially for those with varied solubilities. This study introduces a novel metal-phenolic network-based core-shell recombinant high-density lipoprotein nanocarrier (SSPH-MPN@rHDL) for co-delivering multiple bioactive components from Salvia miltiorrhiza and Carthamus tinctorius, including salvianic acid A (SAA), salvianolic acid B (SAB), protocatechuic aldehyde (PCA), hydroxysafflor yellow A (HSYA), and tanshinone IIA (TS-IIA).
View Article and Find Full Text PDFFront Pharmacol
January 2025
Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine, Guangdong Provincial Key Laboratory of Research and Development in Traditional Chinese Medicine, Guangzhou, Guangdong, China.
BuShao Tiaozhi Capsule (BSTZC), a novel drug in China, has been used to treat hyperlipidemia (HLP) in clinical practice for many years. Despite our previous studies suggesting that BSTZC can treat HLP, there is a lack of a rapid and systematic method to explore its active components. Therefore, in this study, we aimed to investigate the active components and mechanisms of BSTZC in treating HLP by integrating serum pharmacology, pharmacokinetics, network analysis, and experimental validation.
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