1,721,054 research outputs found
Red Yeast Rice for the Improvement of Lipid Profiles in Mild-to-Moderate Hypercholesterolemia: A Narrative Review
Full text linkReducing low-density lipoprotein cholesterol (LDL-C) levels is a key target for lowering cardiovascular risk and preventing atherosclerotic cardiovascular disease (ASCVD). Red yeast rice (RYR) is a nutraceutical widely used as a lipid-lowering dietary supplement. The main cholesterol-lowering components of RYR are monacolins, particularly monacolin K, which is structurally identical to lovastatin and targets the same key enzyme of cholesterol biosynthesis. RYR supplementation reduces LDL-C levels by approximately 15-34% versus placebo, with a similar effect to low-dose, first-generation statins in subjects with mild-to-moderate dyslipidemia. RYR has also demonstrated beneficial reductions of up to 45% versus placebo in the risk of ASCVD events in secondary prevention studies. RYR at a dose that provides about 3 mg/d of monacolin K is well tolerated, with an adverse event profile similar to that of low-dose statins. RYR is therefore a treatment option for lowering LDL-C levels and ASCVD risk for people with mild-to-moderate hypercholesterolemia who are ineligible for statin therapy, particularly those who are unable to implement lifestyle modifications, and also for people who are eligible for statin therapy but who are unwilling to take a pharmacologic therapy
Efficacy and safety of inclisiran a newly approved FDA drug: a systematic review and pooled analysis of available clinical studies.
Full text linkNovel anti-obesity drugs and plasma lipids
No full textObesity is a health problem of global, epidemic proportions and a major risk factor
for chronic diseases resulting in accelerated morbidity and mortality. Dyslipidemia
with a predominance of small dense LDL, impaired functionality of HDL particles, and
increased serum levels of remnant particles due to impaired clearance of triglyceriderich
lipoproteins significantly heightens cardiovascular events in obese subjects.
Pharmacotherapy in combination with lifestyle modification is the primary approach
to reduce obesity-related cardiovascular risk. Although there are several potential
anti-obesity drugs, orlistat is the only agent that remains available in the market.
Lorcaserin and Qsymia®, approved by the US FDA last year, and contrave with potential
approval in 2014, are new anti-obesity drugs with promising therapeutic effects.
Although these drugs can be associated with adverse side effects, these agents have
favorable effects on lipid profiles. However, the need for safer anti-obesity agents is
clear
Management of pregnancy-related hypertensive disorders in patients infected with SARS CoV-2: pharmacological and clinical issues.
No full textCoronavirus-19 disease (COVID-19) continues to spread throughout the world. It is known that among patients with hypertension, diabetes, chronic respiratory disease, or cardiovascular diseases, COVID-19 is associated with greater morbidity and mortality compared with patients without these conditions. This correlation is of great importance in pregnant women affected by COVID-19, since it usually leads to the development of a serious clinical complication. In particular, managing hypertensive disorders in pregnancy can be problematic because antihypertensive medications may interact pharmacologically with drugs used to treat COVID-19. This review focuses on the safety of drug treatment for COVID-19 in pregnant women treated with antihypertensive medication. Several databases were searched to identify relevant literature. A few antihypertensive drugs and antithrombotic treatments are known for having a beneficial effect in the management of hypertension and hypertensive disorders in pregnancy. In this review, we focus on the expected drug-drug interactions with the experimental agents most often used to treat COVID-19. The current indications for the management of hypertension-related disorders in pregnancy maintain their validity, while the risk of pharmacological interaction with the currently tested anti-SARS-CoV-2 medications is relatively low
STATINS AND NEW-ONSET DIABETES
No full textStatins are highly efficacious lipid modifying agents that reduce the risk for cardiovascular (CV) events in both primary and secondary prevention settings. However, statins affect molecular mechanisms which adversely impact on insulin sensitivity and β-cell function, thereby increasing risk for new onset diabetes mellitus (NOD). Defining the mechanisms involved is the focus of considerable current investigation. The statins reduce the risk for CV events in normoglycemic patients as well as in those with diabetes mellitus (DM) and their benefits outweigh the risk of inducing NOD. We review the clinical evidence for NOD with statin treatment, as well as the potential mechanisms involved. Our literature search was based on PubMed and Scopus listings. Further large studies are needed to elucidate both the association between NOD and statin use and the underlying mechanisms
Improvement in arterial stiffness after short-term treatment with PCSK9 inhibitors.
No full textAlirocumab and evolocumab are fully human monoclonal
antibodies that inhibit proprotein convertase
subtilisinekexin type 9 [iPCSK9]. These agents reduce the
risk of cardiovascular and limb events in statin-treated
subjects [1,2]. However, the effect of iPCSK9 on arterial
stiffness has not yet been reported. In this report, we
present data from two patients who experienced an
impressive improvement in carotid-femoral pulse wave
velocity [cfPWV] after short-term treatment with iPCSK
Emerging Therapies For Raising Hdl-C And Augmenting Hdl Particle Functionality
No full textHigh-density lipoprotein particles are highly complex polymolecular aggregates capable of performing a remarkable range of atheroprotective functions. Considerable research is being performed throughout the world to develop novel pharmacologic approaches to: (1) promote apoprotein A-I and HDL particle biosynthesis; (2) augment capacity for reverse cholesterol transport so as to reduce risk for the development and progression of atherosclerotic disease; and (3) modulate the functionality of HDL particles in order to increase their capacity to antagonize oxidation, inflammation, thrombosis, endothelial dysfunction, insulin resistance, and other processes that participate in arterial wall injury. HDL metabolism and the molecular constitution of HDL particles are highly complex and can change in response to both acute and chronic alterations in the metabolic milieu. Many innovative approaches have reached phase 2 and phase 3 development. To date, some of these interventions have been shown to positively impact rates of coronary artery disease progression. However, none of them have as yet been shown to significantly reduce risk for cardiovascular events. In the next 3-5 years a variety of pharmacologic interventions for modulating HDL metabolism and functionality will be tested in large, randomized, prospective outcomes trials. It is hoped that one or more of these therapeutic approaches will result in the ability to further reduce risk for cardiovascular events once low-density lipoprotein cholesterol and non-HDL-cholesterol targets have been attained
New Obesity Indices and Adipokines in Normotensive Patients and Patients With Hypertension: Comparative Pilot Analysis.
No full textWe compared the obesity parameters and selected adipokines—leptin, adiponectin, and resistin—in obese patients with
hypertension and normotensive patients. A total of 67 nondiabetic obese outpatients were divided into 2 groups: A–hypertensive
and B–normotensive. Serum levels of leptin, adiponectin, resistin, and insulin were measured.Weight, height, waist circumference,
and hip circumference were measured to calculate waist-to-hip ratio (WHR), weight-to-height ratio, visceral adiposity index, and
body adiposity index (BAI). Among patients with hypertension, significant positive correlations were observed between leptin
and body mass index and BAI (r = .31 and r = .63, respectively). In normotensive patients, leptin positively correlated with BAI
(r = .73, P < .01) and negatively with WHR (r = -.55, P < .0001); adiponectin negatively correlated with WHR (r = .38, P < .01)
and BAI (r = .52; P < .0001), and resistin negatively correlated with WHR (r = -.36, P < .05). In conclusion, visceral obesity and
leptin are associated with hypertension in obese patients
Efficacy and safety of Armolipid Plus®: an updated PRISMA compliant systematic review and meta-analysis of randomized controlled clinical trials.
Full text linkArmolipid Plus® is a multi-constituent nutraceutical that claims to improve lipid profiles. The aim of this PRISMA compliant systematic review and meta-analysis was to globally evaluate the efficacy and safety of Armolipid Plus® on the basis of the available randomized, blinded, controlled clinical trials (RCTs). A systematic literature search in several databases was conducted in order to identify RCTs assessing the efficacy and safety of dietary supplementation with Armolipid Plus®. Two review authors independently identified 12 eligible studies (1050 included subjects overall) and extracted data on study characteristics, methods, and outcomes. Meta-analysis of the data suggested that dietary supplementation with Armolipid Plus® exerted a significant effect on body mass index (mean difference (MD) = -0.25 kg/m2, p = 0.008) and serum levels of total cholesterol (MD = -25.07 mg/dL, p < 0.001), triglycerides (MD = -11.47 mg/dL, p < 0.001), high-density lipoprotein cholesterol (MD = 1.84 mg/dL, p < 0.001), low-density lipoprotein cholesterol (MD = -26.67 mg/dL, p < 0.001), high sensitivity C reactive protein (hs-CRP, MD = -0.61 mg/L, p = 0.022), and fasting glucose (MD = -3.52 mg/dL, p < 0.001). Armolipid Plus® was well tolerated. This meta-analysis demonstrates that dietary supplementation with Armolipid Plus® is associated with clinically meaningful improvements in serum lipids, glucose, and hs-CRP. These changes are consistent with improved cardiometabolic health
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