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100 Cholesterol Studies
From 1994 to 1998
Life Flow One
The Solution For Heart Disease

by
Karl Loren

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HealthGate Document

Record 1 from database: MEDLINE
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Title

Nutritional requirements of infants and children with respect to cholesterol and related compounds.

Author

Barness LA

Address

University of South Florida College of Medicine, Tampa 33612.

Source

Am J Med Genet, 1994 May, 50:4, 353-4

Abstract

Cholesterol is an enigmatic, essential metabolite. Breast milk contains significant quantities of cholesterol, yet human infants thrive on cholesterol-free diets. Recommendations to lower serum cholesterol are widespread, yet low serum cholesterol is associated with poorly understood morbidity. Serum cholesterol is increased with diets high in fat, yet dietary cholesterol has relatively little effect on serum concentrations. Smith-Lemli-Opitz syndrome, marked with extremely low serum cholesterol, may serve as a human model for the evaluation of absorption and metabolism of dietary cholesterol.

Language of Publication

English

Unique Identifier

94270406

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MeSH Heading (Major)

Child Nutrition|*; Cholesterol|BL/*ME; Cholesterol, Dietary|*ME

MeSH Heading

Cell Membrane|CH; Child, Preschool; Human; Hypobetalipoproteinemia|PA; Infant; Infant Nutrition; Milk, Human|CH; Myelin Sheath|PH; Nutritional Requirements

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0148-7299

Country of Publication

UNITED STATES

Record 2 from database: MEDLINE
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Title

Comparable efficacy of hydrogenated versus nonhydrogenated plant sterol esters on circulating cholesterol levels in humans.

Author

Jones PJ; Ntanios F

Address

School of Dietetics and Human Nutrition, McGill University, Quebec, Canada.

Source

Nutr Rev, 1998 Aug, 56:8, 245-8

Abstract

A recent study in The Netherlands compared the effects of margarine enriched with different vegetable oil sterols with margarine containing sitostanol-ester on plasma total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol concentrations. Margarine with sterolesters from soybean oil (mainly esters from sitosterol, campesterol, and stigmasterol) was as effective as a margarine with sitostanol-ester in lowering blood total and LDL cholesterol levels without affecting HDL cholesterol levels.

Language of Publication

English

Unique Identifier

98406639

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MeSH Heading (Major)

Lipoproteins, HDL Cholesterol|BL/*DE; Lipoproteins, LDL Cholesterol|BL/*DE; Plant Oils|AD/*PD; Sterols|AD/*PD

MeSH Heading

Adult; Aged; Comparative Study; Double-Blind Method; Female; Human; Hydrogenation; Male; Margarine; Middle Age; Randomized Controlled Trials

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0029-6643

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Lipoproteins, HDL Cholesterol); 0 (Lipoproteins, LDL Cholesterol); 0 (Plant Oils); 0 (Sterols); 8029-82-1 (Margarine)

Record 3 from database: MEDLINE
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Title

Epidemiologic aspects of lipid abnormalities.

Author

Criqui MH; Golomb BA

Address

University of California, San Diego, Department of Family and Preventive Medicine, La Jolla 92093-0607, USA.

Source

Am J Med, 1998 Jul 6, 105:1A, 48S-57S

Abstract

Existing cholesterol guidelines aimed at preventing cardiovascular disease emphasize the role of total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol in lipid management decisions, with a subsidiary role for high-density lipoprotein (HDL) cholesterol in guiding treatment and little role for triglycerides. In this article, epidemiologic evidence is reviewed relating to the independent value of lipid factors in prediction of cardiovascular disease risk, including TC, LDL cholesterol, HDL cholesterol, very-low-density lipoprotein (VLDL) cholesterol and triglycerides, LDL particle size ("pattern B"), and the TC/HDL-cholesterol ratio. Several observations are highlighted. Triglycerides appear to be an independent risk factor in specific populations. Postprandial triglycerides may be superior to fasting triglycerides as a predictor of risk. LDL particle size does not have independent predictive value after adjustment for triglycerides. Particular emphasis is placed on the observation that the single most predictive lipid factor is the TC/HDL-cholesterol ratio, which implicitly incorporates information on both LDL and triglycerides in the numerator. This is the best predictor both of outcome and of treatment benefit, and its predictive value appears to be maintained into older age. It is concluded that increasing emphasis should be placed on the TC/HDL cholesterol ratio in epidemiologic analyses and in monitoring patients on therapy for dyslipidemia.

Language of Publication

English

Unique Identifier

98370765

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MeSH Heading (Major)

Cholesterol|*BL; Coronary Disease|BL/*ET/*MO; Hyperlipidemia|BL/*CO/*EP

MeSH Heading

Age Distribution; Age Factors; Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Lipoproteins, VLDL Cholesterol|BL; Risk; Sex Distribution; Sex Factors; United States|EP

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-9343

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Lipoproteins, HDL Cholesterol); 0 (Lipoproteins, LDL Cholesterol); 0 (Lipoproteins, VLDL Cholesterol); 57-88-5 (Cholesterol)

Record 4 from database: MEDLINE
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Title

Perspectives in the treatment of dyslipidemias in the prevention of coronary heart disease.

Author

Borgia MC; Medici F

Address

UniversitÄa Degli Studi di Roma La Sapienza, Italy.

Source

Angiology, 1998 May, 49:5, 339-48

Abstract

In this review the indications for the available treatments for dyslipidemias in the prevention of coronary heart disease (CHD) are considered, and their efficacy according to the latest studies is analyzed. As data sources the authors used the main multicenter studies performed in the last twenty years to evaluate primary and secondary prevention of CHD by correcting dyslipidemias as well as the results of meta-analyses of these studies. All treatments considered were found effective in preventing CHD morbidity and mortality to some extent. In particular, the combination of diet with niacin or hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitors seems to give the best results. These drugs induce a marked reduction of total and low-density lipoprotein (LDL) cholesterol and an increase of high-density lipoprotein (HDL) cholesterol concentrations. The use of diet, niacin, and HMG CoA reductase inhibitors reduces total as well as specific mortality. Treatment of dyslipidemia to prevent CHD depends on the pattern and severity of dyslipidemia, the presence of overt CHD, and the patient's response to diet. Pharmacologic treatment should be started only after dietary modifications have been tried and must be combined with diet. Drug side effects must also be considered, for they may affect patient compliance. High levels of total and LDL and low levels of HDL cholesterol are major risk factors for coronary atherosclerosis. Correcting lipid abnormalities can reduce the risk of development or progression of CHD. Diet and drugs are the main instruments available to normalize lipid levels. The choice of drug to combine with diet must be based on its specific effects on lipid metabolism, side effects, and efficacy in reducing CHD.

Language of Publication

English

Unique Identifier

98252199

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MeSH Heading (Major)

Coronary Disease|MO/*PC/PP; Hyperlipidemia|BL/DH/DT/*TH

MeSH Heading

Antilipemic Agents|AE/PD/TU; Cholesterol|BL; Combined Modality Therapy; Coronary Arteriosclerosis|ET/PC; Disease Progression; Human; Hydroxymethylglutaryl-CoA Reductase Inhibitors|TU; Lipids|ME; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Meta-Analysis; Multicenter Studies; Niacin|TU; Patient Compliance; Primary Prevention; Risk Factors; Survival Rate; Treatment Outcome

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0003-3197

Country of Publication

UNITED STATES

Record 5 from database: MEDLINE
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Title

Management of lipid disorders in the elderly.

Author

Playford DA; Watts GF

Address

University Department of Medicine, Royal Perth Hospital, Western Australia, Australia. daviplay@cyllene.uwa.edu.au

Source

Drugs Aging, 1997 Jun, 10:6, 444-62

Abstract

Cardiovascular disease has been inseparable from aging in developed societies and, as a result, it is the commonest cause of mortality in elderly populations. Atherosclerosis is associated with the progressive vascular accumulation of cholesterol-laden lipoproteins, and is linearly associated with the plasma level of low density lipoprotein (LDL) cholesterol. Clinical trials in patients aged < 65 years have conclusively shown that treatment of hypercholesterolaemia decreases the incidence of cardiovascular events and total mortality. However, few conclusive data are available regarding the treatment of hypercholesterolaemia in elderly patients. Extrapolation from clinical trials suggests that lipid lowering treatment in well selected elderly patients is effective in preventing cardiovascular events and is an efficient use of healthcare resources. In addition to cholesterol, high triglyceride and low high-density lipoprotein levels appear to be significant predictors of coronary artery disease in elderly patients. We do not advocate the indiscriminate screening of healthy elderly patients who have no other cardiovascular risk factors, because the marginal overall benefits are probably small and the costs of widespread screening and treatment high. On the other hand, chronological age itself cannot be considered a barrier to the screening and treatment of patients who have a good quality of life but have other cardiovascular risk factors and/or definite cardiovascular disease. Subgroup analysis of major clinical trials suggests that the aims of treatment should be to lower the LDL cholesterol level to 3.2 mmol/L (125 mg/dl), or the total cholesterol level to 5.2 mmol/L (200 mg/dl). Occasionally, multiple drug therapy is required to achieve this target, but statins (HMG-CoA reductase inhibitors) are the most commonly used first-line agents. With aggressive lowering of plasma lipid levels in this way, a reduction in clinical events is paralleled by regression of atheroma detectable by angiography, and an improvement in endothelial function. Global reduction of risk factors in elderly patients should always be undertaken, including dietary therapy, weight reduction in viscerally obese patients, postmenopausal estrogen replacement, smoking cessation, treatment of hypertension and control of diabetes mellitus. A secondary cause of dyslipidaemia should also be sought. The role of antioxidants is still not clear, but they are probably of little benefit in elderly patients. With the widespread use of effective, well tolerated treatments for lipid disorders in younger patients, significant improvements have already been attained in the morbidity and mortality associated with coronary artery disease. Since the current life expectancy at age 65 years is nearly 20 years in most Western countries, secondary prevention may increase the quality of life and the independent lifespan, even if eventual mortality is not delayed.

Language of Publication

English

Unique Identifier

97349993

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MeSH Heading (Major)

Aging|*BL/PH; Anticholesteremic Agents|*TU; Cardiovascular Diseases|EP/*PC; Hyperlipidemia|CL/DH/*DT/PP

MeSH Heading

Aged; Clinical Trials; Cost-Benefit Analysis; Diabetes Mellitus, Non-Insulin-Dependent|CO; Drug Therapy, Combination; Estrogens|DF; Female; Glucose Intolerance|CO; Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Lipoproteins, VLDL Cholesterol|BL; Male; Quality of Life; Risk Factors; Treatment Outcome

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

1170-229X

Country of Publication

NEW ZEALAND

Record 6 from database: MEDLINE
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Title

Butter, margarine and serum lipoproteins.

Author

Zock PL; Katan MB

Address

Department of Human Nutrition, Wageningen Agricultural University, The Netherlands.

Source

Atherosclerosis, 1997 May, 131:1, 7-16

Abstract

Intake of trans fatty acids unfavorably affects blood lipoproteins. As margarines are a major source of trans, claims for the advantages of margarines over butter need to be scrutinized. Here we review dietary trials that directly compared the effects of butter and margarine on blood lipids. We identified 20 studies in which subjects had stable body weights, and margarine and butter were exchanged in the diet at constant energy and fat intake. We calculated the changes in average blood lipid levels between study diets (49 comparisons) as a function of the percentage of calories as margarine substituted for butter. Replacing 10% of calories from butter by hard high-trans stick margarines lowered total serum cholesterol by 0.19, LDL by 0.11, and HDL by 0.02 mmol/l, and did not affect the total/HDL cholesterol ratio. Soft low-trans tub margarines decreased total cholesterol by 0.25 and LDL by 0.20 mmol/l, did not affect HDL, and decreased the total/HDL cholesterol ratio by 0.20. Based on the total/HDL cholesterol ratio, replacement of 30 g of butter per day by soft tub margarines would theoretically predict a reduction in coronary heart disease risk of 10%, while replacement of butter by hard, high-trans margarines would have no effect. Replacing butter by low-trans soft margarines favorably affects the blood lipoprotein profile and may reduce the predicted risk of coronary heart disease, but high-trans hard margarines probably confer no benefit over butter.

Language of Publication

English

Unique Identifier

97324043

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MeSH Heading (Major)

Butter|*; Dietary Fats|*AD; Lipoproteins|*BL; Margarine|*

MeSH Heading

Cholesterol|BL; Coronary Disease|PC; Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; MEDLINE; Support, Non-U.S. Gov't

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0021-9150

Country of Publication

IRELAND

Record 7 from database: MEDLINE
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Title

Dietary phytosterols as cholesterol-lowering agents in humans.

Author

Jones PJ; MacDougall DE; Ntanios F; Vanstone CA

Address

School of Dietetics and Human Nutrition, McGill University, MontrÆeal, QC, Canada.

Source

Can J Physiol Pharmacol, 1997 Mar, 75:3, 217-27

Abstract

Phytosterols (plant sterols), abundant in fat-soluble fractions of plants, are consumed at levels of 200-400 mg/day in Western diets. Chemically resembling cholesterol, phytosterols inhibit the absorption of cholesterol. Phytosterol consumption in human subjects under a wide range of study conditions has been shown to reduce plasma total and low density lipoprotein (LDL) cholesterol levels; however, the response varies widely. Greater cholesterol-lowering efficacy occurs with consumption of the saturated phytosterol sitostanol versus sitosterol or campesterol. Most studies report no effect of phytosterol administration in high density lipoprotein (HDL) cholesterol or triglyceride levels, although certain evidence exists for an HDL cholesterol raising effect of sitostanol. Phytosterol absorption is limited, although serum phytosterol levels have proven to be important indicators of both cholesterol absorption and synthesis. Serum phytosterols correlate with HDL cholesterol level. In addition, higher phytosterol/cholesterol ratios appear in HDL versus LDL particles, suggesting the existence of an intrinsic phytosterol action, in addition to the extrinsic effect on cholesterol absorption. In conclusion, addition to diet of the phytosterol sitostanol represents an effective means of improving circulating lipid profiles to reduce risk of coronary heart disease.

Language of Publication

English

Unique Identifier

97307514

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MeSH Heading (Major)

Anticholesteremic Agents|*AD/AE/ME; Cholesterol|AD/*BL/ME; Diet|*; Phytosterols|*AD/AE/ME

MeSH Heading

Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0008-4212

Country of Publication

CANADA

Record 8 from database: MEDLINE
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Title

Theoretical considerations of what regulates low-density-lipoprotein and high-density-lipoprotein cholesterol.

Author

Dietschy JM

Address

Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-8887, USA.

Source

Am J Clin Nutr, 1997 May, 65:5 Suppl, 1581S-1589S

Abstract

The concentration of cholesterol carried in low-density-lipoprotein cholesterol (LDL-C) is predominantly dictated by metabolic events occurring in liver. LDL-C is derived from the intravascular metabolism of very-low-density lipoproteins, and, in every species, this lipoprotein particle is predominantly cleared by liver through receptor-dependent mechanisms. In addition to cholesterol absorbed from the diet, sterol is also synthesized within the body and this synthesis occurs predominantly in extrahepatic organs. When the amount of cholesterol input into the body is increased, there is expansion of the pools of sterol within liver cells and down-regulation of the receptors responsible for clearing LDL-C from the bloodstream. As a consequence, the concentration of LDL-C in plasma increases. When dietary cholesterol intake is kept constant, some long-chain saturated fatty acids further suppress hepatic LDL receptor activity whereas several unsaturated fatty acids have the opposite effect. These regulatory events are apparently articulated through the ability of these fatty acids to shift intracellular cholesterol between a regulatory and a storage pool. High-density lipoproteins, in contrast, function primarily to move excess cholesterol from the extrahepatic organs to liver for excretion. Although the concentration of high-density-lipoprotein cholesterol in the plasma may be influenced by the rate of apolipoprotein A-I production or the activity of cholesterol ester transfer protein, it is less clear whether dietary long-chain fatty acids have any effect on these processes. The regulatory effects of the saturated and unsaturated long-chain fatty acids on LDL-C concentrations can be shown in a variety of experimental animals and also in humans.

Language of Publication

English

Unique Identifier

97275728

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MeSH Heading (Major)

Lipoproteins, HDL Cholesterol|BL/*ME/PH; Lipoproteins, LDL Cholesterol|BL/*ME/PH; Liver|*ME; Models, Biological|*

MeSH Heading

Animal; Apolipoprotein A-I|ME; Cholesterol, Dietary|ME/PD; Fatty Acids|ME/PD; Human

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-9165

Country of Publication

UNITED STATES

Record 9 from database: MEDLINE
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Title

Low-density lipoprotein removal methods by membranes and future perspectives.

Author

Matsuda Y; Malchesky PS; Nosé Y

Address

Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.

Source

Artif Organs, 1996 Apr, 20:4, 346-54

Abstract

Since the application by Thompson et al. in 1975 of plasma exchange for the treatment of 2 patients with familial hyperlipidemia, plasma purification techniques for selective low-density lipoprotein (LDL) removal (i.e., LDL apheresis) have been developed and adopted for the management of this disease. Thermofiltration is one of the LDL apheresis systems that utilizes membrane techniques developed by Nose and Malchesky's group in 1985. This article reviews its rationale, in vitro studies, animal studies, and clinical investigation. Thermofiltration effectively and selectively removes LDL cholesterol while retaining in the plasma physiologically important macromolecules such as albumin and high-density lipoprotein (HDL) cholesterol. Based on the global view of the treatment of atherosclerosis by LDL apheresis, membrane techniques are as effective, safe, and simpler to apply than other methods. Additionally, these methods are effective for the removal of lipoprotein (a) and fibrinogen; thus, they can address the needs in these application areas.

Language of Publication

English

Unique Identifier

97013885

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MeSH Heading (Major)

Atherosclerosis|*TH; Lipoproteins, LDL Cholesterol|BL/*IP; Membranes, Artificial|*; Plasmapheresis|ST/*TD

MeSH Heading

Animal; Clinical Trials; Dextran Sulfate|CH/ME; Filtration; Heat; Heparin|PD; Human; Immunosorbents|CH/ME; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, VLDL Cholesterol|BL; Molecular Weight; Particle Size; Precipitation; Risk Factors

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0160-564X

Country of Publication

UNITED STATES

Record 10 from database: MEDLINE
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Title

The role of fiber in the treatment of hypercholesterolemia in children and adolescents.

Author

Kwiterovich PO Jr

Address

Department of Pediatrics, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.

Source

Pediatrics, 1995 Nov, 96:5 Pt 2, 1005-9

Abstract

The effect of adding water-soluble fiber to a diet low in total fat, saturated fat, and cholesterol to treat hypercholesterolemic children and adolescents with elevated plasma low-density lipoprotein (LDL) cholesterol levels was assessed. In more than a half-dozen studies, the effect of water-soluble fiber on the LDL cholesterol level ranged from no change to as high as a 23% decrease using oat bran, psyllium, or locust bean gum. The wide range of effects in these studies may be related to the quality of the dietary intervention or to different methods of randomization, blinding, dietary assessment, and laboratory measurement. For example, the addition of supplemented soluble fiber (psyllium) to a step 1 diet may provide additional lowering of LDL cholesterol of 10% to 15%. However, in children consuming the more stringent step 2 diet, the addition of water-soluble fiber may have less additional effects on LDL cholesterol. As recommended by the National Cholesterol Education Program Expert Panel on Blood Cholesterol Levels in Children and Adolescents, dietary therapy, that is, a diet low in total fat, saturated fat, and cholesterol, remains the cornerstone of treatment for children and adolescents with elevated LDL cholesterol levels. The use of foods high in water-soluble fiber that contain no cholesterol and are low in saturated fat remains a good choice in children following a step 1 or step 2 diet. Additional clinical trials in larger numbers of well-defined subjects will be needed to assess further the utility of adding water-soluble fiber supplements to the National Cholesterol Education Program step 1 or step 2 diets.(ABSTRACT TRUNCATED AT 250 WORDS)

Language of Publication

English

Unique Identifier

96067496

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MeSH Heading (Major)

Dietary Fiber|*TU; Hypercholesterolemia|BL/*DH

MeSH Heading

Adolescence; Child; Cholesterol|BL; Cholesterol, Dietary|AD; Diet, Fat-Restricted; Human; Intervention Studies; Lipoproteins, LDL Cholesterol|BL; Nutrition Assessment; Oats; Polysaccharides|TU; Psyllium|TU; Randomized Controlled Trials; Solubility; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0031-4005

Country of Publication

UNITED STATES

Record 11 from database: MEDLINE
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Title

Monounsaturated oils do not all have the same effect on plasma cholesterol.

Author

Truswell AS; Choudhury N

Address

Human Nutrition Unit, University of Sydney, NSW, Australia.

Source

Eur J Clin Nutr, 1998 May, 52:5, 312-5

Abstract

Evidence assembled here indicates that when olive oil forms a major part of dietary fat in controlled human experiments, total and LDL-cholesterols are somewhat higher than when the same amount of fat is one of the modern predominantly monounsaturated oils: low erucic rapeseed or high oleic sunflower oil. Oils rich in monounsaturated fatty acids thus do not all have the same effect on plasma cholesterol. This phenomenon is explicable by consideration of the content of other fatty acids and the non-saponifiable fractions of the different monounsaturated oils. It helps to explain the discrepancy that has existed between the classic experiments (using olive oil), which found monounsaturated oils 'neutral', and some of the more recent experiments which found them more cholesterol-lowering than carbohydrates. Four published meta-analyses are reviewed. The three which included most of the published experiments show that monounsaturated fatty acids (MUFA) have less plasma cholesterol-lowering effect than polyunsaturated fatty acids.

Language of Publication

English

Unique Identifier

98292333

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MeSH Heading (Major)

Cholesterol|*BL; Dietary Fats, Unsaturated|*PD; Fatty Acids, Monounsaturated|AD/*PD

MeSH Heading

Erucic Acids|PD; Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Oleic Acid|PD; Plant Oils|PD

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0954-3007

Country of Publication

ENGLAND

Record 12 from database: MEDLINE
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Title

Management of dyslipidemia in adults.

Author

Ahmed SM; Clasen ME; Donnelly JE

Address

Wright State University School of Medicine, Dayton, Ohio, USA.

Source

Am Fam Physician, 1998 May, 57:9, 2192-2204, 2207-8

Abstract

The importance of treating dyslipidemias based on cardiovascular risk factors is highlighted by the National Cholesterol Education Program guidelines. The first step in evaluation is to exclude secondary causes of hyperlipidemia. Assessment of the patient's risk for coronary heart disease helps determine which treatment should be initiated and how often lipid analysis should be performed. For primary prevention of coronary heart disease, the treatment goal is to achieve a low-density lipoprotein (LDL) cholesterol level of less than 160 mg per dL (4.15 mmol per L) in patients with only one risk factor. The target LDL level in patients with two or more risk factors is 130 mg per dL (3.35 mmol per L) or less. For patients with documented coronary heart disease, the LDL cholesterol level should be reduced to less than 100 mg per dL (2.60 mmol per L). A step II diet, in which the total fat content is less than 30 percent of total calories and saturated fat is 8 to 10 percent of total calories, may help reduce LDL cholesterol levels to the target range in some patients. A high-fiber diet is also therapeutic. The most commonly used options for pharmacologic treatment of dyslipidemia include bile acid-binding resins, HMG-CoA reductase inhibitors, nicotinic acid and fibric acid derivatives. Other possibilities in selected cases are estrogen replacement therapy, plasmapheresis and even surgery in severe, refractory cases.

Language of Publication

English

Unique Identifier

98269154

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MeSH Heading (Major)

Antilipemic Agents|*TU; Cholesterol|*BL; Hyperlipidemia|BL/CL/CO/DH/DT/*TH

MeSH Heading

Adult; Coronary Disease|ET; Dietary Fats|AD; Dietary Fiber|AD; Drug Therapy, Combination; Human; Life Style; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Middle Age; Patient Education; Risk Factors; Teaching Materials

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-838X

Country of Publication

UNITED STATES

Record 13 from database: MEDLINE
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Title

Rationale for use of non-high-density lipoprotein cholesterol rather than low-density lipoprotein cholesterol as a tool for lipoprotein cholesterol screening and assessment of risk and therapy.

Author

Frost PH; Havel RJ

Address

Cardiovascular Research Institute and Department of Medicine, University of California, San Francisco 94143-0326, USA.

Source

Am J Cardiol, 1998 Feb, 81:4A, 26B-31B

Abstract

The plasma level of low-density lipoprotein (LDL) cholesterol is the "gold standard" for estimating the lipoprotein-related risk for complications of atherosclerotic vascular disease. LDL cholesterol concentrations are commonly estimated by the Friedewald formula that requires only the measurement (after overnight fasting) of plasma cholesterol and triglycerides along with high-density lipoprotein (HDL) cholesterol. This value, however, is not in fact a true estimate of LDL cholesterol but rather of LDL cholesterol along with variable, usually smaller, amounts of intermediate-density lipoprotein (IDL) cholesterol and lipoprotein(a). Estimation of LDL cholesterol levels by the Friedewald formula becomes progressively less accurate as plasma triglyceride concentrations increase, and the formula is generally considered inapplicable when triglyceride levels exceed 400 mg/dL. We believe that a very simple measurement-non-HDL cholesterol (serum cholesterol minus HDL cholesterol)-has considerable potential as a screening tool for identifying dyslipoproteinemias, for risk assessment, and for assessing the results of hypolipidemic therapy. Unlike the estimation of LDL cholesterol levels by the Friedewald formula, the estimation of non-HDL cholesterol concentrations requires no assumptions about the relation of very-low-density (VLDL) cholesterol levels to plasma triglyceride concentrations. This method includes all of the cholesterol present in lipoprotein particles now considered to be potentially atherogenic [VLDL, IDL, LDL, and lipoprotein(a)]. This article provides examples of the utility of non-HDL cholesterol concentrations in clinical medicine.

Language of Publication

English

Unique Identifier

98186005

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MeSH Heading (Major)

Atherosclerosis|*DI; Cholesterol|*BL; Coronary Disease|*BL; Lipoproteins|*BL; Lipoproteins, HDL Cholesterol|*BL; Lipoproteins, LDL Cholesterol|*BL

MeSH Heading

Apolipoproteins B|BL; Clinical Trials; Human; Lipids|BL; Lipoproteins, VLDL Cholesterol|BL; Risk Assessment; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Triglycerides|BL

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-9149

Country of Publication

UNITED STATES

Record 14 from database: MEDLINE
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Title

Cholesterol intake and plasma cholesterol: an update.

Author

P2Namara DJ

Address

Egg Nutrition Center, Washington, DC 20006, USA.

Source

J Am Coll Nutr, 1997 Dec, 16:6, 530-4

Abstract

The misperception that dietary cholesterol determines blood cholesterol is held by many consumers in spite of evidence to the contrary. Many studies reported over the past 2 years have shown that dietary cholesterol is not a significant factor in an individual's plasma cholesterol level or cardiovascular disease (CVD) risk. Reports from the Lipid Research Clinics Research Prevalence Study and the Framingham Heart Study have shown that dietary cholesterol is not related to either blood cholesterol or heart disease deaths. In a similar manner, 10 clinical trials (1994 to 1996) of the effects of dietary cholesterol on blood lipids and lipoproteins indicate that addition of an egg or two a day to a low-fat diet has little if any effect on blood cholesterol levels. This observation was noted in young men and women with normal cholesterol levels as well as older subjects with elevated plasms cholesterol concentrations. The consistency of the clinical and the epidemiological data demonstrating that dietary cholesterol has little effect on plasma cholesterol in most individuals raises a number of questions regarding the justification of population wide restrictions on dietary cholesterol intake and egg consumption.

Language of Publication

English

Unique Identifier

98091915

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MeSH Heading (Major)

Cholesterol|*BL/ST; Cholesterol, Dietary|*AD/AE/ST

MeSH Heading

Cardiovascular Diseases|CI/PC; Clinical Trials; Female; Human; Male

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0731-5724

Country of Publication

UNITED STATES

Record 15 from database: MEDLINE
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Title

Effect of ursodeoxycholic acid on hepatic cholesterol metabolism.

Author

Einarsson K

Address

Dept. of Gastroenterology and Hepatology, Karolinska Institute, Huddinge University Hospital, Sweden.

Source

Scand J Gastroenterol Suppl, 1994, 204:, 19-23

Abstract

Oral administration of ursodeoxycholic acid (UDCA) renders bile unsaturated with cholesterol by reducing the hepatic output of cholesterol. Theoretically, several mechanisms may be of importance. In the present overview, the effect of treatment with UDCA on hepatic cholesterol metabolism is evaluated, in particular the influence on hepatic cholesterol synthesis, 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase activity, bile acid synthesis, 7 alpha-hydroxylation of cholesterol, and esterification of cholesterol--acyl coenzyme A: cholesterol acetyltransferase (ACAT) activity. It is apparent that UDCA treatment does not inhibit the hepatic HMG CoA reductase activity. Neither is ACAT activity or the cholesteryl ester content changed by UDCA. The catabolism of cholesterol to bile acids is unaffected or slightly increased during administration of UDCA. It is concluded that a stimulated degradation of cholesterol to bile acids may partly explain the decrease in hepatic secretion of cholesterol obtained during UDCA administration. It is suggested that the reduction in cholesterol absorption from the intestine seen during UDCA therapy may also be of importance.

Language of Publication

English

Unique Identifier

95125380

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MeSH Heading (Major)

Cholesterol|BI/*ME; Liver|*DE/EN/*ME; Ursodeoxycholic Acid|*PD/TU

MeSH Heading

Acyl Coenzyme A|BI/DE; Cholelithiasis|DT/ME; Cholesterol 7 alpha-Monooxygenase|BI/DE; Human; Hydroxymethylglutaryl CoA Reductases|BI/DE; Support, Non-U.S. Gov't

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0085-5928

Country of Publication

NORWAY

Record 16 from database: MEDLINE
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Title

Effect of long-chain fatty acids on low-density-lipoprotein-cholesterol metabolism.

Author

Woollett LA; Dietschy JM

Address

Department of Internal Medicine, University of Texas, Southwestern Medical Center at Dallas 75235-8887.

Source

Am J Clin Nutr, 1994 Dec, 60:6 Suppl, 991S-996S

Abstract

The concentration of cholesterol in the low-density-lipoprotein (LDL) fraction of plasma is one of the major risk factors for coronary heart disease. Steady-state concentrations of LDL cholesterol in the plasma are determined primarily by the production rate and the rate of removal of LDL cholesterol from the circulation by receptor-dependent transport. The magnitude of these two processes is affected by the type of fatty acid in the diet. Saturated fatty acids with 14 and 16 carbon atoms suppress receptor-dependent LDL-cholesterol transport into the liver, increase the LDL-cholesterol production rate, and raise the plasma LDL-cholesterol concentration. The 9-cis 18:1 fatty acid restores receptor activity, lowers the production rate, and decreases the plasma LDL-cholesterol concentration. In contrast with these fatty acids, the 18:0 and 9-trans 18:1 fatty acids are biologically inactive and so do not change the circulating LDL-cholesterol concentration.

Language of Publication

English

Unique Identifier

95067752

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MeSH Heading (Major)

Dietary Fats|*ME; Fatty Acids|*ME; Lipoproteins, LDL Cholesterol|*BL

MeSH Heading

Animal; Cholesterol Esters|AN; Cholesterol, Dietary|ME; Human; Liver|CH; Receptors, LDL|ME; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Triglycerides|ME

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-9165

Country of Publication

UNITED STATES

Record 17 from database: MEDLINE
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Title

Defects in steroidogenic enzymes. Discrepancies between clinical steroid research and molecular biology results.

Author

Zachmann M

Address

Department of Pediatrics, University of Zurich, Kinderspital, Switzerland.

Source

J Steroid Biochem Mol Biol, 1995 Jun, 53:1-6, 159-64

Abstract

Molecular biology has clarified the understanding of steroidogenic enzyme genetics. Nevertheless, there are discrepancies between fundamental and clinical experience. (1) Why do patients with "pure" 17 alpha-hydroxylase or 17,20-desmolase deficiency exist, when one cytochrome regulates both steps? A case of interest is discussed, who had "pure" 17,20-desmolase deficiency until adolescence, but additional 17 alpha-hydroxylase deficiency thereafter. (2) In 11 beta-hydroxylase deficiency, it was puzzling to find 18-hydroxylated compounds, and, in isolated hypoaldosteronism, normal cortisol, since 11 beta- and 18-hydroxylation were thought to be regulated together. This has now been explained by differences in the fasciculata and glomerulosa. The occurrence of 11 beta-hydroxylase deficiency of 17-hydroxylated steroids only, however, remains enigmatic. (3) 3 beta-Hydroxysteroid dehydrogenase deficiency does not only seem to exist in classic (mutations of type II gene), but also in late-onset cases. In them, no molecular basis could be found. (4) Also, in cholesterol side-chain cleavage, there is an inequity: while evidently one cytochrome regulates 20- and 22-hydroxylation, pregnenolone is formed when 20 alpha OH-cholesterol, but not when cholesterol, is added to adrenal tissue of deficient patients. Other factors (promoters, fusion proteins, adrenodoxin, cAMP-dependent expression of genes, and/or proteases), or hormonal replacement in patients may be responsible for these discrepancies.

Language of Publication

English

Unique Identifier

95352443

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MeSH Heading (Major)

Steroid Hydroxylases|*DF/*GE; Steroids|*BI

MeSH Heading

Aldehyde-Lyases|DF/GE; Cholesterol|ME; Cholesterol Monooxygenase (Side-Chain-Cleaving)|DF/GE; Cytochrome P-450|DF/GE; Human; Steroid 17 alpha-Monooxygenase|DF/GE; Support, Non-U.S. Gov't

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0960-0760

Country of Publication

ENGLAND

Record 18 from database: MEDLINE
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Title

Extracorporeal removal of lipids by dextran sulfate cellulose adsorption.

Author

Olbricht CJ

Address

Department of Nephrology, Medical School Hannover, Germany.

Source

Artif Organs, 1996 Apr, 20:4, 332-5

Abstract

Extracorporeal removal of low-density lipoprotein (LDL) cholesterol by dextran sulfate adsorption is indicated in patients with diet and drug resistant hyper-cholesterolemia to prevent or to regress coronary heart disease. Plasma separation is the first step in the process, followed by adsorption of LDL cholesterol and lipoprotein (a) (Lp[a]) to negatively charged dextran sulfate covalently bound to cellulose beads. The reduction per treatment in LDL cholesterol is 65-75% and in Lp(a) 40-60%. In most patients one treatment per week is sufficient to reduce mean LDL to 100-150 mg/dl. Minor side effects occur in 2-6% of treatments. Major side effects are rare. In uncontrolled studies long-term treatment was associated with inhibition of progression and induction of regression of coronary artery disease. LDL apheresis by dextran sulfate may increase blood perfusion of some tissues, and preliminary results indicate a beneficial effect on therapy resistant nephrotic syndrome with hypercholesterolemia.

Language of Publication

English

Unique Identifier

97013881

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MeSH Heading (Major)

Hypercholesterolemia, Familial|*TH; Lipoproteins, LDL Cholesterol|BL/*IP; Plasmapheresis|*

MeSH Heading

Adsorption; Blood Proteins|IP/ME; Cellulose|CH/ME; Dextran Sulfate|CH/ME; Human; Lipoproteins, VLDL Cholesterol|BL/IP; Triglycerides|BL/IP

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0160-564X

Country of Publication

UNITED STATES

Record 19 from database: MEDLINE
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Title

Apolipoprotein E polymorphism and dietary plasma cholesterol response.

Author

Tikkanen M; Huttunen JK; Pajukanta PE; Pietinen P

Address

Department of Medicine, University of Helsinki, Finland.

Source

Can J Cardiol, 1995 Oct, 11 Suppl G:, 93G-96G

Abstract

All studies have demonstrated a strong association between plasma cholesterol and apoE phenotypes in the following order: E4/E4 > E4/E3 > E3/E3 > E3/E2. It has been thought possible that the apoE gene might be involved in the modulation of dietary plasma cholesterol responses, perhaps explaining the differences in cholesterol concentrations. Some dietary intervention studies have suggested that apoE4 individuals react to dietary change with exaggerated cholesterol responses. In one study, apoE4/E4 individuals responded by increased cholesterol reductions during low fat intake, and by increased cholesterol elevations during switchback to high fat diet. Plausible mechanisms have been postulated which could explain such differences. However, other studies have reported no differences in plasma lipid responses among apoE phenotypes. The studies cannot be directly compared because of different designs and study populations with differing apoE allele frequencies. Thus the possible role of genetic variation in the apoE gene in the modulation of dietary plasma lipid responses remains to be confirmed in prospective dietary studies, involving diets both rich and poor in fat and cholesterol.

Language of Publication

English

Unique Identifier

96062899

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MeSH Heading (Major)

Apolipoproteins E|*GE; Cholesterol, Dietary|*BL; Polymorphism (Genetics)|*; Variation (Genetics)|*

MeSH Heading

Human; Lipoproteins|BL; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Phenotype

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0828-282X

Country of Publication

CANADA

Record 20 from database: MEDLINE
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Title

Role of dietary fish protein in the regulation of plasma lipids.

Author

Jacques H; Gascon A; Bergeron N; Lavigne C; Hurley C; Deshaies Y; Moorjani S; Julien P

Address

DÆepartement de nutrition humaine et de consommation, UniversitÆe Laval, Ste-Foy, QuÆebec.

Source

Can J Cardiol, 1995 Oct, 11 Suppl G:, 63G-71G

Abstract

The following studies have been carried out to compare the effects of fish protein with other dietary proteins on plasma cholesterol and lipoproteins in animal models and in humans. In rabbits, fish protein has been shown to induce relatively variable effects compared to casein and soy protein on serum cholesterol depending in part on the origin of dietary lipids with which it is combined. In a protein-lipid interaction study, casein, soy or cod protein were combined with corn or coconut oil. Casein and soy protein in the presence of corn oil induced lower serum cholesterol levels despite its combination with either corn or coconut oil. This is in part due to serum high density lipoprotein (HDL) cholesterol concentrations, which were consistently higher with cod protein than with either casein or soy protein, regardless of the dietary lipid source. In rabbits, this rise in HDL cholesterol was associated with a decrease in very low density lipoprotein (VLDL) triglycerides and an increase in postheparin plasma lipoprotein lipase activity. The effects of lean white fish on plasma lipoproteins also have been investigated in post and premenopausal women fed a low-fat, high P/S (polyunsaturated/saturated fat) ratio diet. In postmenopausal women, lean white fish compared with other animal protein products induced higher concentrations of plasma cholesterol, LDL-apolipoprotein (apo) B and HDL cholesterol, mainly in the HDL3 fraction. In premenopausal women, lean white fish induced lower concentrations of VLDL triglycerides and higher concentrations of LDL-apoB in plasma.(ABSTRACT TRUNCATED AT 250 WORDS)

Language of Publication

English

Unique Identifier

96062895

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MeSH Heading (Major)

Cholesterol|*BL; Dietary Proteins|AN/ME/*PD; Lipoproteins|*BL; Seafood|*

MeSH Heading

Amino Acids|AN; Animal; Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, VLDL Cholesterol|BL; Support, Non-U.S. Gov't; Triglycerides|BL

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0828-282X

Country of Publication

CANADA

Record 21 from database: MEDLINE
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Title

What benefit can be derived from treating normocholesterolemic patients with coronary artery disease?

Author

Brown G; Stewart BF; Zhao XQ; Hillger LA; Poulin D; Albers JJ

Address

Department of Medicine, University of Washington School of Medicine, Seattle, USA.

Source

Am J Cardiol, 1995 Sep, 76:9, 93C-97C

Abstract

Controversy still remains regarding the possible clinical or arteriographic benefit of intensive lipid-altering therapy in patients who have coronary artery disease and apparently normal lipid levels. Resolution of this controversy appears to depend on an improved understanding of the role of variables other than total or low density lipoprotein cholesterol levels. A comparison of the "normolipidemic" subgroup of The Familial Atherosclerosis Treatment Study patients and The Harvard Atherosclerosis Reversibility Project patients indicates that low levels of high density lipoprotein cholesterol and elevated levels of apolipoprotein B appear to increase considerably the likelihood of benefit from intensive lipid-altering therapy. Other risk-related variables such as systolic blood pressure and lipoprotein(a) further contribute to the prediction of risk and possibly to the potential for treatment benefit.

Language of Publication

English

Unique Identifier

96016228

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MeSH Heading (Major)

Anticholesteremic Agents|*TU; Cholesterol|*BL; Coronary Disease|BL/*DT/RA

MeSH Heading

Adult; Apolipoproteins B|BL; Coronary Angiography; Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Middle Age; Randomized Controlled Trials; Risk Factors; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-9149

Country of Publication

UNITED STATES

Record 22 from database: MEDLINE
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Title

Range of serum cholesterol values in the population developing coronary artery disease.

Author

Kannel WB

Address

Department of Medicine, Evans Memorial Research Foundation, Boston University School of Medicine/Framingham Heart Study, Massachusetts, USA.

Source

Am J Cardiol, 1995 Sep, 76:9, 69C-77C

Abstract

Blood lipids have been established as fundamental to atherogenesis, and there is a better understanding of the pathogenesis of atherosclerosis and of the various pharmacologic agents available to counter the mechanisms involved. However, more optimal lipid levels must be established for treatment of both the healthy population and persons already with coronary artery disease (CAD). In the Framingham Study cohort, those with elevated serum total cholesterol (> 275 mg/dl) had an increased risk of adverse outcomes whether healthy or with CAD. Compared with persons with cholesterol levels < 200 mg/dl (< 5.17 mmol/liter), the risk ratios for patients with elevated cholesterol levels were 3.8 for reinfarction, 2.6 for CAD mortality, and 1.9 for overall mortality. The prevalence of cholesterol levels > or = 240 mg/dl (> or = 6.21 mmol/liter) in persons who had sustained myocardial infarction was 35-52% in men and 66% in women, but 20% of myocardial infarctions occurred in people who had cholesterol levels < 200 mg/dl (< 5.17 mmol/liter). The average levels of serum total cholesterol and low density lipoprotein (LDL) cholesterol (225 mg/dl [5.82 mmol/liter] and 150 mg/dl [3.88 mmol/liter], respectively) at which CAD events occurred in men were below the levels recommended for treatment according to the guidelines of the National Cholesterol Education Program. In women, these levels were only slightly above the guideline levels. The average cholesterol levels at which CAD events occurred were substantially higher in women and decreased with age. Also, a steady decline in the average cholesterol levels of patients over the decades reflected chiefly the aging of the cohort.(ABSTRACT TRUNCATED AT 250 WORDS)

Language of Publication

English

Unique Identifier

96016225

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MeSH Heading (Major)

Cholesterol|*BL; Coronary Disease|*BL/EP/PC

MeSH Heading

Adult; Aged; Anticholesteremic Agents|TU; Apolipoproteins B|BL; Female; Human; Hyperlipidemia|DT/EP; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Male; Middle Age; Prevalence; Sex Factors; Support, U.S. Gov't, P.H.S.

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-9149

Country of Publication

UNITED STATES

Record 23 from database: MEDLINE
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Title

Worldwide distribution of blood lipids and lipoproteins in childhood and adolescence: a review study.

Author

Brotons C; Ribera A; Perich RM; Abrodos D; Magana P; Pablo S; Terradas D; Fernández F; Permanyer G

Address

Cardiology Department, Hospital General Universitari Vall d'Hebron, Barcelona, Spain. brotons@ar.vhebron.es

Source

Atherosclerosis, 1998 Jul, 139:1, 1-9

Abstract

Review and pooled analysis of the relevant worldwide literature was investigated from 1975 to 1996. Eighteen surveys out of 54 were suitable for analysis according to the selection criteria. This represents a total of 60494 observations from 26 countries all over the world. Data suggests differences as great as 76 mg/dl when comparing northern European countries to black African children. The overall curve of cholesterol with age observed in the pooled population indicates a pre-adolescent peak and then a slightly inverse change is observed for both boys and girls, from 3 to 12 years old being almost coincident absolute values. Beyond age 12, values for boys continue to slightly decrease to age 16, while for girls values tend to increase through this age-range. The curve in the late teens (16-18 years) tends to reach pre-teen levels for both sexes, although girls have consistently higher absolute values than boys. There is a great variation in the specific age-sex and race levels of cholesterol among different populations or even in the same populations over a period of time. However, an apparently universal pattern of an early rise, a fall, and a subsequent rise in mean values of total cholesterol by age from the preadolescence to late teens is observed. More data are needed on total cholesterol and lipid fractions between late school age and mid-adulthood.

Language of Publication

English

Unique Identifier

98363466

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MeSH Heading (Major)

Lipids|*BL; Lipoproteins|*BL

MeSH Heading

Adolescence; Child; Child, Preschool; Cholesterol|BL; Female; Human; Lipoproteins, HDL Cholesterol|BL; Male; Racial Stocks; Reference Values; Triglycerides|BL; World Health Organization

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0021-9150

Country of Publication

IRELAND

CAS Registry/EC Number

0 (Lipids); 0 (Lipoproteins); 0 (Lipoproteins, HDL Cholesterol); 0 (Triglycerides); 57-88-5 (Cholesterol)

Record 24 from database: MEDLINE
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Title

Pharmacological control of phagocyte function: inhibition of cholesterol accumulation.

Author

Paoletti R; Bellosta S; Bernini F

Address

Institute of Pharmacological Sciences, University of Milan, Italy.

Source

Ann N Y Acad Sci, 1997 Dec 15, 832:, 322-9

Abstract

Phagocytes play a major role in several diseases. In particular mononuclear phagocyte-derived foam cells have a prominent role in the development of the atherosclerotic lesions. Macrophages are present in all stages of atherogenesis; they internalize lipoproteins and accumulate cholesterol. Moreover, lipid-filled macrophages, by secreting extracellular matrix-degrading enzymes, may weaken rupture-prone atherosclerotic plaques, thus increasing the probability of precipitating atherosclerotic acute symptoms (i.e., myocardial infarction, angina, etc.). Therefore, control of cellular functions and cholesterol accumulation in macrophages represent pharmacological targets against atherosclerosis. In our laboratory we studied the effect of calcium antagonists on cellular cholesterol esterification in cultured macrophages. We also demonstrated that the HMG-CoA reductase inhibitors (vastatins) fluvastatin and simvastatin prevented cholesterol deposition in cultured human and murine macrophage by inhibiting modified LDL endocytosis. Interestingly, vastatin activity was more pronounced in cholesterol-loaded macrophages (i.e., foam cells) than in normal cells. In conclusion, in vitro pharmacological control of cholesterol accumulation in macrophages may be achieved with some calcium antagonists and vastatins independently of their effects on blood pressure or cholesterolemia.

Language of Publication

English

Unique Identifier

98369683

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MeSH Heading (Major)

Cholesterol|*ME; Hydroxymethylglutaryl-CoA Reductase Inhibitors|*PD; Macrophages|DE/*PH; Phagocytes|DE/*PH

MeSH Heading

Animal; Cholesterol Esters|ME; Human; Macrophages, Peritoneal|DE/PH; Nifedipine|PD; Phagocytosis|DE; Progesterone|PD; Verapamil|PD

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0077-8923

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Cholesterol Esters); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 21829-25-4 (Nifedipine); 52-53-9 (Verapamil); 57-83-0 (Progesterone); 57-88-5 (Cholesterol)

Record 25 from database: MEDLINE
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Title

Current thinking in lipid lowering.

Author

Ballantyne CM

Address

Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA.

Source

Am J Med, 1998 Jun 22, 104:6A, 33S-41S

Abstract

In addition to elevated low-density lipoprotein (LDL) cholesterol, which has been conclusively proven to play a critical role in atherogenesis and coronary artery disease (CAD), other lipoprotein abnormalities are associated with CAD, such as reduced high-density lipoprotein (HDL) cholesterol; increased triglyceride-rich lipoproteins (very low density and intermediate-density lipoproteins); increased lipoprotein(a); small, dense LDL; and LDL with increased susceptibility to oxidation. Other, nonlipid factors such as homocysteine, fibrinogen, C-reactive protein, and soluble cell adhesion molecules may also have a role in risk stratification. The present US treatment guidelines, which focus on LDL cholesterol, stratify risk assessment and intensity of treatment by the presence of CAD; therefore, noninvasive imaging techniques such as ultrafast computed tomography and positron-emission tomography (PET) of the heart, which enable early detection of CAD, are useful in risk assessment. Because the influence of risk factors depends on their severity and combination, global risk assessment provides a necessary guide to the appropriate intensity of treatment. Agents are available that reduce LDL cholesterol and triglyceride and increase HDL cholesterol; although lipoprotein(a), LDL particle size, LDL oxidation, and homocysteine can also be altered, the clinical effects of such alterations are not known. Combination therapy that simultaneously improves multiple components of the lipid profile may provide additional benefit compared with monotherapy. To provide cost-effective treatment to the most patients, high-risk patients must be identified through systematic screening. Then each patient should be treated with the most cost-effective agent(s) that will enable achievement of the lipid levels recommended in the guidelines.

Language of Publication

English

Unique Identifier

98347992

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MeSH Heading (Major)

Antilipemic Agents|*TU; Coronary Disease|BL/DT/*PC; Lipoproteins|*BL

MeSH Heading

Human; Lipoproteins, HDL Cholesterol|BL; Lipoproteins, LDL Cholesterol|BL; Risk Assessment; Risk Factors; Triglycerides|BL

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0002-9343

Country of Publication

UNITED STATES

CAS Registry/EC Number

0 (Antilipemic Agents); 0 (Lipoproteins); 0 (Lipoproteins, HDL Cholesterol); 0 (Lipoproteins, LDL Cholesterol); 0 (Triglycerides)

Record 26 from database: MEDLINE
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Title

Assessing the observed relationship between low cholesterol and violence-related mortality. Implications for suicide risk.

Author

Kaplan JR; Muldoon MF; Manuck SB; Mann JJ

Address

Comparative Medicine Clinical Research Center, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1040, USA. kaplan@cpm.bgsm.edu

Source

Ann N Y Acad Sci, 1997 Dec, 836:, 57-80

Abstract

Health advocacy groups advise all Americans to restrict their dietary intake of saturated fat and cholesterol as an efficacious and safe way to lower plasma cholesterol concentrations and thus reduce the risk of coronary heart disease and other atherosclerotic disorders. However, accumulating evidence suggests that naturally low or clinically reduced cholesterol is associated with increased nonillness mortality (principally suicide and accidents). Other evidence suggests that such increases in suicide and traumatic death may be mediated by the adverse changes in behavior and mood that sometimes accompany low or reduced cholesterol. These observations provided the rationale for an ongoing series of studies in monkeys designed to explore the hypothesis that alterations in dietary or plasma cholesterol influence behavior and that such effects are potentiated by lipid-induced changes in brain chemistry. In fact, the investigations in monkeys reveal that reductions in plasma cholesterol increase the tendency to engage in impulsive or violent behavior through a mechanism involving central serotonergic activity. It is speculated that the cholesterol-serotonin-behavior association represents a mechanism evolved to increase hunting or competitive foraging behavior in the face of nutritional threats signaled by a decline in total serum cholesterol (TC). The epidemiological and experimental data could be interpreted as having two implications for public health: (1) low-cholesterol may be a marker for risk of suicide or traumatic death and (2) cholesterol lowering may have adverse effects for some individuals under some circumstances.

Language of Publication

English

Unique Identifier

98279766

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MeSH Heading (Major)

Cholesterol|BL/*PH; Serotonin|*PH; Suicide|*; Violence|*

MeSH Heading

Animal; Cholesterol, Dietary|AE; Dietary Fats|AE; Human; Meta-Analysis; Risk Factors

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0077-8923

Country of Publication

UNITED STATES

Record 27 from database: MEDLINE
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Title

Estrogen replacement therapy and cardiovascular protection: lipid mechanisms are the tip of an iceberg.

Author

Nasr A; Breckwoldt M

Address

Department of Obstetrics and Gynecology, University of Assiut, Egypt.

Source

Gynecol Endocrinol, 1998 Feb, 12:1, 43-59

Abstract

Cardiovascular disease remains a major cause of mortality among postmenopausal women. After menopause, atherogenesis is promoted by a number of metabolic and vascular changes. A multitude of observational clinical studies have come to the conclusion that estrogen replacement therapy (ERT) reduces cardiovascular risk by approximately 50% and that estrogen's favorable effects on the lipid profile can explain only 25-50% of the overall observed reduction. Estrogens are now known to have potent anti-atherogenic properties through lipid and non-lipid mechanisms; both will be highlighted in view of the recent literature. Estrogens induce favorable changes on lipids and lipoproteins, partly by increasing HDL-cholesterol and decreasing both LDL-cholesterol and lipoprotein (a). Non-lipid mechanisms of estrogen action include decreasing insulin resistance, serum fibrinogen, factor VII and plasminogen activator inhibitor-1 (PAI-1). Moreover, estrogens maintain endothelial cell integrity, decrease expression of adhesion molecules, lower systemic blood pressure, promote vasodilatation, decrease platelet aggregability, inhibit vascular smooth muscle cell proliferation, possess potent antioxidant and calcium antagonist activities, inhibit adrenergic responses and downregulate platelet and monocyte reactivity. Also mentioned are recent reports linking estrogen to the renin-angiotensin system, relaxin, serotonin and homocysteine. What was once thought of as a simple action is now being increasingly appreciated as a complex, multifaceted mechanism, which serves to prove that estrogen is a powerful cardiovascular agent.

Language of Publication

English

Unique Identifier

98187458

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MeSH Heading (Major)

Atherosclerosis|ET/*PC; Cardiovascular Diseases|*PC; Estrogen Replacement Therapy|*; Estrogens|*TU; Lipids|*ME/PH

MeSH Heading

Aged; Endothelium|CY/PH; Female; Hemostasis|PH; Human; Insulin|ME; Lipoproteins, HDL Cholesterol|ME; Lipoproteins, LDL Cholesterol|ME; Menopause; Middle Age; Muscle, Smooth, Vascular|PH; Somatropin|PH

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0951-3590

Country of Publication

ENGLAND

Record 28 from database: MEDLINE
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Title

Stable angina pectoris: recent advances in predicting prognosis and treatment.

Author

Willerson JT

Address

Texas Heart Institute, Houston, USA.

Source

Adv Intern Med, 1998, 43:, 175-202

Abstract

Substantial progress has been made in the ability to predict individuals at the highest risk of acute myocardial infarction and occlusive cerebrovascular events, as well as in the ability to reduce these risks by vigorous reductions in serum cholesterol and LDL cholesterol concentrations. The development of stents has been a clear advance in the interventional treatment of coronary heart disease in that stents provide an effective acute treatment for significant coronary narrowings in symptomatic patients and reduce the risk of restenosis lesions subsequently. Heparin-coated stents appear to provide additive protection against the risk of thrombosis and the future development of restenosis lesions. Preliminary studies done on human carotid atherosclerotic plaque suggest that unstable plaque might be detected in the future by their temperature heterogeneity, which helps identify plaques with relatively thin fibrous caps, marked inflammation, and adjacent lipid pools.

Language of Publication

English

Unique Identifier

98167082

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MeSH Heading (Major)

Angina Pectoris|BL/ET/PC/*TH; Coronary Disease|BL/ET/PC/*TH

MeSH Heading

Angioplasty, Transluminal, Percutaneous Coronary; Anticoagulants|AD; Antilipemic Agents|TU; Atherosclerosis|DI/PA/PP; Body Temperature; Carotid Artery Diseases|DI/PA/PP; Cerebrovascular Disorders|ET/PC; Cholesterol|BL; Coronary Artery Bypass; Coronary Thrombosis|PC; Disease Progression; Forecasting; Heparin|AD; Human; Lipids|AN; Lipoproteins, LDL Cholesterol|BL; Myocardial Infarction|ET/PC; Prognosis; Recurrence; Risk Factors; Stents

Publication Type

JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL

ISSN

0065-2822

Country of Publication

UNITED STATES

Record 29 from database: MEDLINE
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Title

Comparison of efficacy and cost among lipid-lowering agents in patients with primary hypercholesterolemia [see comments]

Author

Lacour A; Derderian F; LeLorier J

Address

Centre de recherche, Centre hospitalier de l'UniversitÆe de MontrÆeal, HÈotel-Dieu, QuÆebec.

Source

Can J Cardiol, 1998 Mar, 14:3, 355-61

Abstract

OBJECTIVE: To compare efficacy and cost of lipid-lowering agents in patients with primary hypercholesterolemia. DESIGN: A meta-analysis was conducted to determine estimates of efficacy for lipid-lowering agents. Efficacy was defined as the change in the ratio of total cholesterol:high density lipoprotein (HDL) induced by treatment. This ratio was selected because of its good predictive value for the risk of coronary disease. Lipid-lowering agents were grouped into three categories according to the decrease in the total cholesterol:HDL ratio. Acquisition prices for drugs were obtained from the Quebec provincial drug formulary. An analysis determined which drugs in each category 'purchased' the greatest decrease in ratio for the lowest cost. SETTING: Clinical trial study centres. PATIENTS: The population analyzed had a mean baseline total cholesterol:HDL ratio of 7.3, an average age of 50.5 years and mean proportion of men of 62.5%. INTERVENTIONS: Twelve lipid-lowering therapies at various doses were investigated. RESULTS: Drugs that were mo