M H Davidson

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..Emphasis is on newer data regarding the effect of statins in retarding progression of atherosclerosis or even inducing regression of atherosclerosis...

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..This article reviews the strategies for targeting HDL cholesterol to optimize outcomes in CHD...

..This article reviews the clinical efficacy and use of colesevelam HCL for the management of dyslipidemia...

..The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) has identified non-HDL-C as a secondary therapeutic target in these patients, but treatment goals may not be reached with statin monotherapy alone...

..In order to optimize patient outcomes, clinicians should be aware of specific patient characteristics, such as advancing age, gender, body mass index, or glomerular filtration rate, which predict muscle and hepatic statin toxicity...

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..Global risk reduction with aggressive low-density lipoprotein reduction and through the additional normalization of glucose levels and blood pressure can help to reduce absolute risk in this very high-risk population...

..Human clinical trial data with TAK-475, a novel and potent inhibitor of squalene synthase, have not yet been published...

..This review sets forth compelling data that starting patients on or switching to high-efficacy LDL-C-lowering therapy enhances achievement of NCEP ATP III guidelines outside of the controlled trial setting...

..This study was designed to evaluate the efficacy and safety of torcetrapib, a cholesteryl ester transfer protein (CETP) inhibitor, in subjects with low high-density lipoprotein cholesterol (HDL-C) levels...

..As yet, however, cardiovascular endpoint data for rosuvastatin are not available...

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..These combined effects support the use of omega-3 fatty acids as a valuable clinical tool for the treatment of hypertriglyceridemia...

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..This review summarizes the clinical data regarding the efficacy and safety of bile acid sequestrants in this specialized population...

..Because niacin has recognized cardiovascular benefits, promoting patient awareness of factors that can minimize niacin-induced flushing can help enhance the tolerability of this valuable dyslipidemic agent...

..This article presents a review of the biologic actions of HDL that can serve as a potential basis for antiatherosclerotic activity and discusses strategies for targeting HDL for CHD risk reduction...

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..CETP inhibition as a therapeutic strategy remains a valid option to be tested with a CETP inhibitor that does not share torcetrapib's off-target effects...

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..Coadministration of statin and fenofibrate monotherapies is frequently used to treat patients with dyslipidemia; however, a fixed-dose combination (FDC) tablet is not currently marketed...

..This article reviews current options for the therapeutic management of HDL cholesterol, including discussion of novel agents aimed at reducing cardiovascular disease risk in patients with low levels of HDL cholesterol...

..Risk assessment strategies and new data about cardiovascular risk of interest to family physicians are presented here...

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..Both niacin (nicotinic acid) and fibrates are recommended as options for combination with a statin in this setting. Data from ongoing prospective outcomes studies are needed to evaluate the efficacy and safety of these combinations...

..Although each of these novel therapies effectively lowers LDL-C, challenges remain in the clinical development to assess long-term safety...

..In light of the cost and time involved to complete morbidity trials demonstrating the benefit of potential antiatherosclerotic agents, surrogate imaging trials are necessary to expedite the regulatory approval process...

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..However, at this time Lp-PLA(2) cannot be recommended as a target of therapy...

..Postrosuvastatin AE reporting patterns were comparable to those seen with other statins and did not resemble cerivastatin...

..Thus, the clinical trial experience with ezetimibe/simvastatin suggests that ezetimibe does not enhance or aggravate the muscle effects of simvastatin...

..The available statin drugs have similar pharmacodynamic properties but are not equal in low-density lipoprotein cholesterol (LDL-C)-lowering efficacy...

..The results from this study, which was conducted in a routine clinical practice setting, indicate the opportunities and the need for better monitoring and management of lipid levels in patients with atherosclerosis...

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..Gene therapies to reduce low-density lipoproteins and increase high-density lipoproteins are on the horizon, but the ability to safely prolong gene expression in humans will require the development of novel vectors...

..This review discusses the need for comprehensive management of all abnormalities in a given patient's lipoprotein profile and for the use of combinations of anti-lipidemic medications, when indicated...

..Ezetimibe + statin had a safety profile similar to statin monotherapy. Coadministration of ezetimibe + statin offers a well-tolerated, highly efficacious new treatment strategy for patients with hypercholesterolemia...

..In the post-marketing surveillance for rosuvastatin, there have been reports of rhabdomyolysis, but the incidence rate, when corrected for prescription utilisation, is similar to other statins following initial approval...

..Most of those (75%) with cardiovascular disease in NEPTUNE II would be considered very high risk and candidates for aggressive therapy to reach the new optional treatment goals...

..This trend portends an ever-growing need for the aggressive and judicious use of different antilipidemic medication(s) in patients at risk for all forms of atherosclerotic vascular disease...

..HIV lipodystrophy is associated with a marked risk of coronary artery disease (CAD), and more aggressive management of the dyslipidemia is likely necessary to improve the prognosis...

..This article discusses the role of combination therapy in managing CAD and in achieving optional targets in high-risk patient populations...

..The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study in 10,000 patients with Type 2 diabetes mellitus is testing the efficacy and safety of fenofibrate/statin combination...

..There is a need for new formulations that have improved bioavailability and eliminate the requirement for administration with food...

..Lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, and rosuvastatin are the available statins in the United States...

..Plant sterol esters reduce cholesterol absorption and lower circulating blood cholesterol concentrations when incorporated into the habitual diet...

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..CONCLUSIONS: Combination colesevelam and lovastatin was efficacious and well tolerated, resulting in additive decreases in LDL cholesterol levels whether or not both agents were administered simultaneously...

..Although modest, the effect of 10.2 g PSH/d on LDL cholesterol (relative to the control) persisted throughout the 24-wk treatment period, indicating potential for long-term benefit...

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..Thus, it can be concluded that HMG-CoA reductase inhibitors are well tolerated, effective treatments for hypercholesterolaemia...

..0 g/day arm (-13.3%, p < 0.05). DISCUSSION: The results of this study indicate that phytosterol esters are well tolerated and show no evidence of adverse effects at a daily intake of up to 9.0 g of phytosterols for eight weeks...

..Colesevelam, recently approved by the US FDA, represents a valuable non-absorbed alternative in the armamentarium against hypercholesterolaemia, both for monotherapy and combination therapy, as an adjunct to diet and exercise...

..Both treatments were well tolerated...

..The elderly population, while at high risk for CVD, is currently undertreated. Statins can effectively lower low-density lipoprotein cholesterol levels and lessen the risk of CVD for this population...

..05 - < 0.001). CONCLUSION: The results of this study demonstrate the beneficial effects of simvastatin in patients with hypertriglyceridemia...

..The purpose of this study was to assess the efficacy and safety of ezetimibe administered with simvastatin in patients with primary hypercholesterolemia...

..No hospitalized cases of the index AEs were observed in study subjects during the 6-month period before initiation of the lipid-lowering drug. Statin monotherapy as currently prescribed is generally well tolerated and safe...

..This fact has focused increased attention on treating abnormalities of non-high-density lipoprotein-cholesterol (non-HDL-C), HDL-C, and triglycerides in national guidelines and has intensified interest in combination therapy...

..The effects of each type of therapy and potential adverse effects should also be considered...

..While studies of relatively short duration have suggested that thiazolidinediones such as pioglitazone might reduce progression of CIMT in persons with diabetes, the results of longer studies have been less clear...

..Clinicians should be alert to the potential for drug-drug interactions to minimize the risk of myopathy during long-term statin therapy in patients at high risk for coronary heart disease...

..001). Mean percent reductions from baseline in the LDL cholesterol/HDL cholesterol ratio were 52%, 39%, and 30% for rosuvastatin 10 mg, simvastatin 20 mg, and pravastatin 20 mg, respectively, in these 2 trials...

..Selecting the starting dose of atorvastatin using a treatment algorithm achieves NCEP ATP III LDL-cholesterol goals in the majority of patients and minimizes the need for dose titration...

..The metabolic syndrome is common in patients receiving lipid-lowering therapy in an office-based setting. Three recent definitions resulted in similar estimates of its prevalence...

..This article reviews emerging therapeutic strategies for the management of dyslipidemia in patients with the MS...

..To assess the lipid-altering efficacy and safety of ezetimibe/simvastatin single tablet product compared with rosuvastatin at the approved usual starting, next highest, and maximum doses...

..This article discusses several safety and regulatory considerations for the use of combination therapy for dyslipidemia...

..Ezetimibe 10 mg/simvastatin 80 mg lowers LDL by approximately 60% and has been demonstrated to be superior to the highest doses of atorvastatin and rosuvastatin for lowering LDL and raising high-density lipoprotein...

..Previous studies have shown that effects on high-density lipoprotein cholesterol (HDL-C) may differ among statins...

..The study compared low-density lipoprotein cholesterol (LDL-C) reduction obtained after switching patients on a statin therapy to rosuvastatin or simvastatin in real-world clinical practice...

..Lipid management in clinical practice has been suboptimal with a significant proportion of patients not achieving recommended cholesterol levels. A reason for low goal attainment may be the limited use of upward dose titration...

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..Practical guidance in the form of recommendations to health professionals who manage the coronary artery disease risk of patients with statin therapy is provided...

..In this article, the authors review the use of combination therapy as a strategy for risk reduction in CAD...

..0 mmol/L was achieved by 79% to 92% in rosuvastatin groups compared with 52% to 81% in atorvastatin groups. Drug tolerability was similar across treatments...

..This study examined the effects of darapladib, a selective lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) inhibitor, on biomarkers of cardiovascular (CV) risk...

..64 +/- 0.91 vs. 3.38 +/- 0.98 hours x mmol/L, p = 0.018). These results suggest that high-fiber oat cereal influenced postprandial triglyceride and free fatty acid levels, which may have implications regarding cardiovascular disease risk...

..For diabetic patients who require additional LDL lowering, ezetimibe may provide a safe combination to a statin to achieve the LDL goal of less than 100 mg/dL...

..The findings suggest that the use of fenofibrate in combination with statins results in fewer reports of rhabdomyolysis per million prescriptions dispensed than does the use of gemfibrozil...