New research shows a long-term benefit in screening people for CRP, a marker for inflammation, even if they have normal levels of bad cholesterol, because of increased long-term risk for heart attack, stroke and death.
These findings, which will be published online today in the Journal of the American College of Cardiology (JACC), demonstrate that a very simple screening, age plus CRP, can identify individuals who may benefit from statin therapy.
"This study builds on results from the landmark JUPITER trial, which showed that statins can prevent heart disease in people with normal LDL-c, or bad cholesterol, and an increased level of CRP," said Dr. Christie Ballantyne, director of the Center for Cardiovascular Disease Prevention at the Methodist DeBakey Heart & Vascular Center and last author on the study. "We have demonstrated that the cardiovascular disease event rates persist over time, validating that the risks identified in the JUPITER trial persist for nearly seven years."
Questions remained after the JUPITER results were announced in 2008, including whether the observed cardiovascular disease (CVD) event rates would persist with time, because JUPITER was stopped early at two years median follow-up.
"The new study analyzed patients' risk over an average of seven years to determine that CRP is, in fact, a long-term indicator of cardiovascular risk," said Ballantyne, who is also professor of medicine at Baylor College of Medicine. "This is important because approximately one in five men over 50 and women over 60 has a similar profile of increased CRP but normal LDL."
About the study
Methods: After stratification into four groups based on LDL cholesterol (LDL-C) and high-sensitivity CRP (hs-CRP) levels, with cutoffs at 130 mg/dL and 2.0 mg/L respectively, incident CVD events were examined (mean follow-up 6.9 years) and compared.
Results: Of 8,907 age-eligible participants, 18.2 percent (n=1,621) were "JUPITER-eligible" (hs-CRP ?‰?2.0 mg/L, LDL-C
воскресенье, 31 июля 2011 г.
четверг, 28 июля 2011 г.
Statins May Lessen Brain Function, Says ISU Researcher
Research by an Iowa State University scientist suggests that cholesterol-reducing drugs known as statins may lessen brain function.
Yeon-Kyun Shin, a biophysics professor in the department of biochemistry, biophysics and molecular biology, says the results of his study show that drugs that inhibit the liver from making cholesterol may also keep the brain from making cholesterol, which is vital to efficient brain function.
"If you deprive cholesterol from the brain, then you directly affect the machinery that triggers the release of neurotransmitters," said Shin. "Neurotransmitters affect the data-processing and memory functions. In other words -- how smart you are and how well you remember things."
Shin's findings will be published in this month's edition of the journal Proceedings of the National Academy of Sciences of the United States of America.
Cholesterol is one of the building blocks of cells and is made in the liver. Low-density lipoprotein (LDL) -- often referred to as bad cholesterol -- is cholesterol in the bloodstream from the liver on the way to cells in the body. High-density lipoprotein (HDL) -- so-called good cholesterol -- is cholesterol being removed from cells. Too much LDL going to cells and not enough being removed can lead to cholesterol deposits and hardening of the cells.
"If you have too much cholesterol, your internal machinery is not going to be able to take away enough cholesterol from the cells," said Shin. "Then cells harden and you can get these deposits."
Cholesterol-reducing statin drugs are helpful because they keep the liver from synthesizing cholesterol so less of the substance is carried to the cells. This lowers LDL cholesterol.
It is the function of reducing the synthesis of cholesterol that Shin's study shows may also harm brain function.
"If you try to lower the cholesterol by taking medicine that is attacking the machinery of cholesterol synthesis in the liver, that medicine goes to the brain too. And then it reduces the synthesis of cholesterol which is necessary in the brain," said Shin.
In his experiments, Shin tested the activity of the neurotransmitter-release machinery from brain cells without cholesterol present and measured how well the machinery functioned. He then included cholesterol in the system and again measured the protein function. Cholesterol increased protein function by five times.
"Our study shows there is a direct link between cholesterol and the neurotransmitter release," said Shin. "And we know exactly the molecular mechanics of what happens in the cells. Cholesterol changes the shape of the protein to stimulate thinking and memory."
While reducing the cholesterol in the brain may make you have less memory and cognitive skills, more cholesterol in the blood does not make people smarter. Because cholesterol in the blood cannot get across the blood brain barrier, there is no connection to the amount of cholesterol a person eats and brain function.
Shin says that for many people taking cholesterol-lowering statins can be very healthful and they should listen to their doctor when taking medication.
Yeon-Kyun Shin, a biophysics professor in the department of biochemistry, biophysics and molecular biology, says the results of his study show that drugs that inhibit the liver from making cholesterol may also keep the brain from making cholesterol, which is vital to efficient brain function.
"If you deprive cholesterol from the brain, then you directly affect the machinery that triggers the release of neurotransmitters," said Shin. "Neurotransmitters affect the data-processing and memory functions. In other words -- how smart you are and how well you remember things."
Shin's findings will be published in this month's edition of the journal Proceedings of the National Academy of Sciences of the United States of America.
Cholesterol is one of the building blocks of cells and is made in the liver. Low-density lipoprotein (LDL) -- often referred to as bad cholesterol -- is cholesterol in the bloodstream from the liver on the way to cells in the body. High-density lipoprotein (HDL) -- so-called good cholesterol -- is cholesterol being removed from cells. Too much LDL going to cells and not enough being removed can lead to cholesterol deposits and hardening of the cells.
"If you have too much cholesterol, your internal machinery is not going to be able to take away enough cholesterol from the cells," said Shin. "Then cells harden and you can get these deposits."
Cholesterol-reducing statin drugs are helpful because they keep the liver from synthesizing cholesterol so less of the substance is carried to the cells. This lowers LDL cholesterol.
It is the function of reducing the synthesis of cholesterol that Shin's study shows may also harm brain function.
"If you try to lower the cholesterol by taking medicine that is attacking the machinery of cholesterol synthesis in the liver, that medicine goes to the brain too. And then it reduces the synthesis of cholesterol which is necessary in the brain," said Shin.
In his experiments, Shin tested the activity of the neurotransmitter-release machinery from brain cells without cholesterol present and measured how well the machinery functioned. He then included cholesterol in the system and again measured the protein function. Cholesterol increased protein function by five times.
"Our study shows there is a direct link between cholesterol and the neurotransmitter release," said Shin. "And we know exactly the molecular mechanics of what happens in the cells. Cholesterol changes the shape of the protein to stimulate thinking and memory."
While reducing the cholesterol in the brain may make you have less memory and cognitive skills, more cholesterol in the blood does not make people smarter. Because cholesterol in the blood cannot get across the blood brain barrier, there is no connection to the amount of cholesterol a person eats and brain function.
Shin says that for many people taking cholesterol-lowering statins can be very healthful and they should listen to their doctor when taking medication.
понедельник, 25 июля 2011 г.
Blueberries Contain Chemical That May Help Prevent Colon Cancer
A compound found in blueberries shows promise of preventing colon cancer in animals, according to a joint study by scientists at Rutgers University and the U.S. Department of Agriculture. The compound, pterostilbene, is a potent antioxidant that could be developed into a pill with the potential for fewer side effects than some commercial drugs that are currently used to prevent the disease. Colon cancer is considered the second leading cause of cancer death in the United States, the researchers say.
While recent studies have identified a growing number of antioxidants in fruits, vegetables and whole grains that show potential for fighting colon cancer, this is believed to be the first study to demonstrate the cancer-fighting potential of pterostilbene against the disease, the scientists say. Their findings were described at the 233rd national meeting of the American Chemical Society. March is National Colorectal Cancer Awareness Month.
"This study underscores the need to include more berries in the diet, especially blueberries," says study leader Bandaru Reddy, Ph.D., a professor in the Department of Chemical Biology at Rutgers in Piscataway, N.J. Although the blueberry compound won't cure colon cancer, it represents a potential new and attractive strategy for preventing the disease naturally, says Reddy, a leading expert on nutritional factors that influence colon cancer development.
Along with scientists Nanjoo Suh, also of Rutgers, and Agnes Rimando of the USDA's Agricultural Research Service (ARS), Reddy and his associates conducted a small pilot study to determine the effect of pterostilbene on colon cancer. The study included 18 rats that were given a compound (azoxymethane) to induce colon cancer in a manner similar to human colon cancer development. Nine of the animals were then placed on a balanced daily diet, while the other nine were given the same diet supplemented with pterostilbene (at a level of 40 parts per million).
At the end of an eight-week study period, the rats that were fed pterostilbene showed 57 percent fewer pre-cancerous lesions in their colon in comparison to the control group, Reddy and his associates say. Pterostilbene also reduced colonic cell proliferation and inhibited certain genes involved in inflammation, both of which are considered colon cancer risk factors, the researchers say.
Although researchers still do not know the exact cause of colon cancer, the disease has been linked to a high intake of saturated fats and calories, particularly in Western diets. Pterostilbene may be able to reverse this process, possibly by lowering lipids, Reddy says. He cites a recent study by co-author Agnes Rimando, a research chemist at the USDA-ARS, who demonstrated in cell and animal studies that pterostilbene is capable of lowering cholesterol levels. In a related paper also presented at the ACS national meeting, Rimando demonstrated that blueberries, particularly their skins, can lower cholesterol when fed to animals (see AGFD 038 reference below). More studies on the mechanism of action of pterostilbene are needed, the researchers note.
Reddy recently demonstrated that certain COX-2 inhibitors, anti-inflammatory drugs that are used for pain and arthritis, were capable of preventing colon cancer in animals. But studies by others have shown that COX-2 inhibitors also can increase the risk of heart attacks and strokes when used in high doses. Combining pterostilbene with these COX-2 drugs could allow them to be used in lower doses, reducing their risk of adverse side effects, Reddy says. More studies are needed to determine the compound's efficacy and potential for toxicity, he notes.
Pterostilbene is an antioxidant that is similar to resveratrol, an antioxidant identified in grapes and red wine that also is recognized for its anticancer properties. Pterostilbene also is found in grapes, but it is more abundant in blueberries, the researchers say.
In studies by other researchers, blueberries also have shown promise for protecting against memory loss and heart disease. In general, a diet rich in fruits, vegetables and grain is recommended by health experts for the prevention of colon cancer. Funding for this study was provided by the National Cancer Institute.
Mark T. Sampson
The American Chemical Society - the world's largest scientific society - is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.
The paper on this research, AGFD 009, was presented during the symposium, "Natural Products, Diets and Cancer Prevention."
Bandaru S. Reddy, D.V.M., Ph.D., is a research professor in the Department of Chemical Biology, Susan Lehman Cullman Laboratory for Cancer Research, Rutgers University, in Piscataway, N.J.
Related Paper:
Blueberry skins can lower cholesterol in animals - Hamsters with high cholesterol levels that were fed a diet that includes blueberry skins showed significantly lower levels of cholesterol and triglycerides compared to a control group of hamsters that were not fed blueberry skins, according to a joint study by USDA researchers. Pterostilbene, an antioxidant previously shown to lower cholesterol levels in cell and animal studies, is believed to be one of the active ingredients in the blueberry skins, they say. (AGFD 038)
Contact:
Charmayne Marsh
Michael Bernstein
American Chemical Society
While recent studies have identified a growing number of antioxidants in fruits, vegetables and whole grains that show potential for fighting colon cancer, this is believed to be the first study to demonstrate the cancer-fighting potential of pterostilbene against the disease, the scientists say. Their findings were described at the 233rd national meeting of the American Chemical Society. March is National Colorectal Cancer Awareness Month.
"This study underscores the need to include more berries in the diet, especially blueberries," says study leader Bandaru Reddy, Ph.D., a professor in the Department of Chemical Biology at Rutgers in Piscataway, N.J. Although the blueberry compound won't cure colon cancer, it represents a potential new and attractive strategy for preventing the disease naturally, says Reddy, a leading expert on nutritional factors that influence colon cancer development.
Along with scientists Nanjoo Suh, also of Rutgers, and Agnes Rimando of the USDA's Agricultural Research Service (ARS), Reddy and his associates conducted a small pilot study to determine the effect of pterostilbene on colon cancer. The study included 18 rats that were given a compound (azoxymethane) to induce colon cancer in a manner similar to human colon cancer development. Nine of the animals were then placed on a balanced daily diet, while the other nine were given the same diet supplemented with pterostilbene (at a level of 40 parts per million).
At the end of an eight-week study period, the rats that were fed pterostilbene showed 57 percent fewer pre-cancerous lesions in their colon in comparison to the control group, Reddy and his associates say. Pterostilbene also reduced colonic cell proliferation and inhibited certain genes involved in inflammation, both of which are considered colon cancer risk factors, the researchers say.
Although researchers still do not know the exact cause of colon cancer, the disease has been linked to a high intake of saturated fats and calories, particularly in Western diets. Pterostilbene may be able to reverse this process, possibly by lowering lipids, Reddy says. He cites a recent study by co-author Agnes Rimando, a research chemist at the USDA-ARS, who demonstrated in cell and animal studies that pterostilbene is capable of lowering cholesterol levels. In a related paper also presented at the ACS national meeting, Rimando demonstrated that blueberries, particularly their skins, can lower cholesterol when fed to animals (see AGFD 038 reference below). More studies on the mechanism of action of pterostilbene are needed, the researchers note.
Reddy recently demonstrated that certain COX-2 inhibitors, anti-inflammatory drugs that are used for pain and arthritis, were capable of preventing colon cancer in animals. But studies by others have shown that COX-2 inhibitors also can increase the risk of heart attacks and strokes when used in high doses. Combining pterostilbene with these COX-2 drugs could allow them to be used in lower doses, reducing their risk of adverse side effects, Reddy says. More studies are needed to determine the compound's efficacy and potential for toxicity, he notes.
Pterostilbene is an antioxidant that is similar to resveratrol, an antioxidant identified in grapes and red wine that also is recognized for its anticancer properties. Pterostilbene also is found in grapes, but it is more abundant in blueberries, the researchers say.
In studies by other researchers, blueberries also have shown promise for protecting against memory loss and heart disease. In general, a diet rich in fruits, vegetables and grain is recommended by health experts for the prevention of colon cancer. Funding for this study was provided by the National Cancer Institute.
Mark T. Sampson
The American Chemical Society - the world's largest scientific society - is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.
The paper on this research, AGFD 009, was presented during the symposium, "Natural Products, Diets and Cancer Prevention."
Bandaru S. Reddy, D.V.M., Ph.D., is a research professor in the Department of Chemical Biology, Susan Lehman Cullman Laboratory for Cancer Research, Rutgers University, in Piscataway, N.J.
Related Paper:
Blueberry skins can lower cholesterol in animals - Hamsters with high cholesterol levels that were fed a diet that includes blueberry skins showed significantly lower levels of cholesterol and triglycerides compared to a control group of hamsters that were not fed blueberry skins, according to a joint study by USDA researchers. Pterostilbene, an antioxidant previously shown to lower cholesterol levels in cell and animal studies, is believed to be one of the active ingredients in the blueberry skins, they say. (AGFD 038)
Contact:
Charmayne Marsh
Michael Bernstein
American Chemical Society
пятница, 22 июля 2011 г.
You can prevent Alzheimer's by staying lean, eating fruit and vegetables and exercising
Researchers in a new study say that you can prevent Alzheimer's by staying lean, eating lots of fruit and vegetables and exercising, you will also reduce significantly your risk of developing heart disease. High cholesterol during midlife, as well as high blood pressure will increase your risk of developing Alzheimer's and dementia later in life if you do not do anything about it.
Dr. Marilyn Albert, Alzheimer's Association's Medical and Scientific Council (USA), said "There are a variety of lifestyle factors that people can engage in that will reduce their risk of cognitive decline. The brain is much more plastic than we thought. It has more capacity to renew and regenerate. ... We have to tell people that they need to think about their cognitive health in a way that they typically thought about their physical health…..The pathology of Alzheimer's disease develops over 10 years, possibly longer. People should start as early in life as possible."
A Finnish study found that people who are obese in midlife have twice the risk of developing dementia during old age - the study looked at 1,500 people. The people with high cholesterol and blood pressure had six times the risk.
Women who eat plenty of vegetables during their middle-age years are much less likely to lose their cognitive abilities during their 70s than women who did not eat many vegetables. This study looked at 13,000 women. The study was carried out at the Harvard Medical School, led by Dr. Jae Hee Kang.
According to research carried out at the Karolinska Institute, Sweden, activities which combine mental and physical functions significantly reduce one's chances of developing old age dementia. The researchers stressed that the activities must be combined to provide the best protection.
Dr. Marilyn Albert, Alzheimer's Association's Medical and Scientific Council (USA), said "There are a variety of lifestyle factors that people can engage in that will reduce their risk of cognitive decline. The brain is much more plastic than we thought. It has more capacity to renew and regenerate. ... We have to tell people that they need to think about their cognitive health in a way that they typically thought about their physical health…..The pathology of Alzheimer's disease develops over 10 years, possibly longer. People should start as early in life as possible."
A Finnish study found that people who are obese in midlife have twice the risk of developing dementia during old age - the study looked at 1,500 people. The people with high cholesterol and blood pressure had six times the risk.
Women who eat plenty of vegetables during their middle-age years are much less likely to lose their cognitive abilities during their 70s than women who did not eat many vegetables. This study looked at 13,000 women. The study was carried out at the Harvard Medical School, led by Dr. Jae Hee Kang.
According to research carried out at the Karolinska Institute, Sweden, activities which combine mental and physical functions significantly reduce one's chances of developing old age dementia. The researchers stressed that the activities must be combined to provide the best protection.
вторник, 19 июля 2011 г.
Cholesterol Levels Discounted As A Biological Marker For Suicide Risk Among Alcoholics
* Alcoholism is a major risk factor for suicidal behavior.
* Prior research has suggested that cholesterol may be a general biological marker for suicide risk.
* New research discounts cholesterol levels as a biological marker for suicide attempt risk among alcoholics, but identifies a "profile" of patients at risk.
Alcoholism is a major risk factor for suicidal behavior. Previous research has suggested that cholesterol may serve as a biological marker for suicide risk among various psychiatric patient groups. In the March issue of Alcoholism: Clinical & Experimental Research, researchers examine both demographic factors and selected serum lipid concentrations in alcoholic patients. Results do not support an association between cholesterol and suicide attempts; however, they do indicate that alcoholic patients who attempt suicide have a particular profile.
"Up to seven percent of alcoholic patients die from suicide, and about one third of these patients attempt suicide at least once in life," said Eberhard A. Deisenhammer, associate professor of psychiatry at the Innsbruck Medical University and corresponding author for the study. "However, since many alcoholics are reluctant to seek treatment for their problem, a significant portion of potentially suicidal alcoholic patients go undetected. We wanted to investigate if elevated serum cholesterol levels could serve to identify these individuals early enough to help them."
"Recent studies have found that individuals with lower cholesterol levels may be more likely to either attempt or complete suicide, but the evidence is far from established," added Guilherme Luiz Guimaraes Borges, a professor of epidemiology at the Universidad Aut??noma Metropolitana-Xochimilco in Mexico City. "Given that several disorders, as part of their prevention or treatment strategies, call for a reduction in levels of cholesterol in the blood, this study could have repercussions for treatment of several disorders, not just alcoholics and suicidal patients."
Deisenhammer and his colleagues in Austria interviewed and took blood samples from 110 alcoholic patients who were admitted to a psychiatric university hospital department for in-patient treatment. Study participants were grouped according to whether or not they had attempted suicide during their lifetimes: attempters versus non-attempters, and attempters who used a violent versus a non-violent suicide method were compared. Researchers analyzed the participants' blood samples for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides.
Study results do not support an association between cholesterol and suicide attempts.
However, patients who had attempted suicide at least once in their life had a significantly different profile than those with no history of suicide attempts: they were younger, more often smokers, had more frequently co-abused benzodiazepines (central nervous system depressants used mostly to relieve anxiety and insomnia), and scored higher on the global Montgomery and ?…sberg Depression Rating Scale (MADRS) as well as on the MADRS "suicidal thoughts" item. The latter finding would suggest a chronically higher vulnerability for depression and suicidality. Moreover, there were indications that higher serum triglyceride levels may be a risk factor for suicide attempts in the patient population.
"Our results add to several other study findings questioning the importance of low serum total cholesterol as a trait marker for suicidal patients in general," said Deisenhammer. "Maybe future studies will show that there are subgroups of patients for which cholesterol may be useful as a biological suicide marker. Until that time, doctors and relatives of alcoholics should consider the possibility that their patient/husband/colleague may be, or become, suicidal. Until we have easily applicable biological risk markers at our disposal, they will need to assess suicide risk primarily through conversation."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Serum Lipids and Risk Factors for Attempted Suicide in Patients with Alcohol Dependence," were: Theresia Lechner-Schoner, Georg Kemmler, Alexander Ober, Eva Braidt, and Hartmann Hinterhuber of the Department of General Psychiatry at Innsbruck Medical University.
Contact: Eberhard A. Deisenhammer, M.D.
eberhard.deisenhammeruibk.ac.at
Innsbruck Medical University
Guilherme Luiz Guimaraes Borges, Sc.D.
guilhermelgborgesyahoo
Universidad Aut??noma Metropolitana-Xochimilco
Alcoholism: Clinical and Experimental Research
* Prior research has suggested that cholesterol may be a general biological marker for suicide risk.
* New research discounts cholesterol levels as a biological marker for suicide attempt risk among alcoholics, but identifies a "profile" of patients at risk.
Alcoholism is a major risk factor for suicidal behavior. Previous research has suggested that cholesterol may serve as a biological marker for suicide risk among various psychiatric patient groups. In the March issue of Alcoholism: Clinical & Experimental Research, researchers examine both demographic factors and selected serum lipid concentrations in alcoholic patients. Results do not support an association between cholesterol and suicide attempts; however, they do indicate that alcoholic patients who attempt suicide have a particular profile.
"Up to seven percent of alcoholic patients die from suicide, and about one third of these patients attempt suicide at least once in life," said Eberhard A. Deisenhammer, associate professor of psychiatry at the Innsbruck Medical University and corresponding author for the study. "However, since many alcoholics are reluctant to seek treatment for their problem, a significant portion of potentially suicidal alcoholic patients go undetected. We wanted to investigate if elevated serum cholesterol levels could serve to identify these individuals early enough to help them."
"Recent studies have found that individuals with lower cholesterol levels may be more likely to either attempt or complete suicide, but the evidence is far from established," added Guilherme Luiz Guimaraes Borges, a professor of epidemiology at the Universidad Aut??noma Metropolitana-Xochimilco in Mexico City. "Given that several disorders, as part of their prevention or treatment strategies, call for a reduction in levels of cholesterol in the blood, this study could have repercussions for treatment of several disorders, not just alcoholics and suicidal patients."
Deisenhammer and his colleagues in Austria interviewed and took blood samples from 110 alcoholic patients who were admitted to a psychiatric university hospital department for in-patient treatment. Study participants were grouped according to whether or not they had attempted suicide during their lifetimes: attempters versus non-attempters, and attempters who used a violent versus a non-violent suicide method were compared. Researchers analyzed the participants' blood samples for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides.
Study results do not support an association between cholesterol and suicide attempts.
However, patients who had attempted suicide at least once in their life had a significantly different profile than those with no history of suicide attempts: they were younger, more often smokers, had more frequently co-abused benzodiazepines (central nervous system depressants used mostly to relieve anxiety and insomnia), and scored higher on the global Montgomery and ?…sberg Depression Rating Scale (MADRS) as well as on the MADRS "suicidal thoughts" item. The latter finding would suggest a chronically higher vulnerability for depression and suicidality. Moreover, there were indications that higher serum triglyceride levels may be a risk factor for suicide attempts in the patient population.
"Our results add to several other study findings questioning the importance of low serum total cholesterol as a trait marker for suicidal patients in general," said Deisenhammer. "Maybe future studies will show that there are subgroups of patients for which cholesterol may be useful as a biological suicide marker. Until that time, doctors and relatives of alcoholics should consider the possibility that their patient/husband/colleague may be, or become, suicidal. Until we have easily applicable biological risk markers at our disposal, they will need to assess suicide risk primarily through conversation."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Serum Lipids and Risk Factors for Attempted Suicide in Patients with Alcohol Dependence," were: Theresia Lechner-Schoner, Georg Kemmler, Alexander Ober, Eva Braidt, and Hartmann Hinterhuber of the Department of General Psychiatry at Innsbruck Medical University.
Contact: Eberhard A. Deisenhammer, M.D.
eberhard.deisenhammeruibk.ac.at
Innsbruck Medical University
Guilherme Luiz Guimaraes Borges, Sc.D.
guilhermelgborgesyahoo
Universidad Aut??noma Metropolitana-Xochimilco
Alcoholism: Clinical and Experimental Research
суббота, 16 июля 2011 г.
Low CETP Activity Associated With Heart Disease Risk
Although seen as a potential heart disease therapy, raising high-density lipoprotein (HDL) cholesterol levels by inhibiting activity of a transfer protein may not be effective, a new study suggests. Scientists at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University and Boston University School of Medicine found an association between low plasma cholesterol ester transfer protein (CETP) activity and increased risk of heart disease in the Framingham Heart Study population.
CETP is a protein that shuttles cholesterol throughout the body, thus controlling the levels of HDL, low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) in the blood. "Our findings differ from studies suggesting that inhibiting CETP activity would bring a cardiovascular benefit by raising HDL, the so-called good cholesterol credited with lowering the risk of heart disease," says senior author Jose Ordovas, PhD, director of the Nutritional Genomics Laboratory at the USDA HNRCA. "In a clinical trial testing that hypothesis, heart disease unexpectedly advanced in a surprising number of participants."
Based on those results, Ordovas and colleagues examined CETP activity in 1,978 Caucasian men and women with a mean age of 51 years and no history of heart disease. They analyzed 15 to 18 years of study visits looking for first cardiac events including heart failure, heart attack, angina, stroke and peripheral vascular disease.
"By the end of the follow-up period, 320 men and women had experienced their first cardiac event," says Ordovas who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts University. "Participants with low CETP activity were 18 percent more likely to develop cardiovascular disease than people with CETP activity above the median."
A more in-depth investigation of models eliminated the possibility that age, sex and common risk factors such as smoking, weight, diabetes, and cholesterol levels interfered with the findings. The results are published in the December 15 issue of Circulation.
The authors stress the preliminary nature of their data. "The relationship between CETP activity and HDL levels carries many unknowns, including the influence of genetics," Ordovas says, pointing to studies of some Japanese families. "Despite very low levels of CETP activities, they still have high heart disease risk. Other genetic studies question the inhibition of CETP, but there is not enough research to discount the possibility that raising HDL levels through CETP inhibitors may reduce the risk of heart disease," he adds.
This study was funded by the National Heart, Lung and Blood Institute's Framingham Heart Study and the U.S. Department of Agriculture's Agricultural Research Service.
Ramachandran S. Vasan, Michael J. Pencina, Sander J. Robins, Justin P. Zachariah, Guneet Kaur, Ralph B. D'Agostino, and Jose M. Ordovas . "Association of Circulating Cholesteryl Ester Transfer Protein Activity With Incidence of Cardiovascular Disease in the Community" Circulation. 2009;120:2414-2420; published online before print November 30 2009/
Source
Tufts University School of Nutrition
CETP is a protein that shuttles cholesterol throughout the body, thus controlling the levels of HDL, low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) in the blood. "Our findings differ from studies suggesting that inhibiting CETP activity would bring a cardiovascular benefit by raising HDL, the so-called good cholesterol credited with lowering the risk of heart disease," says senior author Jose Ordovas, PhD, director of the Nutritional Genomics Laboratory at the USDA HNRCA. "In a clinical trial testing that hypothesis, heart disease unexpectedly advanced in a surprising number of participants."
Based on those results, Ordovas and colleagues examined CETP activity in 1,978 Caucasian men and women with a mean age of 51 years and no history of heart disease. They analyzed 15 to 18 years of study visits looking for first cardiac events including heart failure, heart attack, angina, stroke and peripheral vascular disease.
"By the end of the follow-up period, 320 men and women had experienced their first cardiac event," says Ordovas who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts University. "Participants with low CETP activity were 18 percent more likely to develop cardiovascular disease than people with CETP activity above the median."
A more in-depth investigation of models eliminated the possibility that age, sex and common risk factors such as smoking, weight, diabetes, and cholesterol levels interfered with the findings. The results are published in the December 15 issue of Circulation.
The authors stress the preliminary nature of their data. "The relationship between CETP activity and HDL levels carries many unknowns, including the influence of genetics," Ordovas says, pointing to studies of some Japanese families. "Despite very low levels of CETP activities, they still have high heart disease risk. Other genetic studies question the inhibition of CETP, but there is not enough research to discount the possibility that raising HDL levels through CETP inhibitors may reduce the risk of heart disease," he adds.
This study was funded by the National Heart, Lung and Blood Institute's Framingham Heart Study and the U.S. Department of Agriculture's Agricultural Research Service.
Ramachandran S. Vasan, Michael J. Pencina, Sander J. Robins, Justin P. Zachariah, Guneet Kaur, Ralph B. D'Agostino, and Jose M. Ordovas . "Association of Circulating Cholesteryl Ester Transfer Protein Activity With Incidence of Cardiovascular Disease in the Community" Circulation. 2009;120:2414-2420; published online before print November 30 2009/
Source
Tufts University School of Nutrition
среда, 13 июля 2011 г.
New Drug Reduces Bad Cholesterol And Triglycerides Without Statin Side Effects
A new drug, eprotirome, has been shown to significantly lower bad cholesterol, triglycerides and Lp(A), without the side effects that statins cause in many people. Results of a study were published in the New England Journal of Medicine.
"Our study has shown a dramatic reduction in the dangerous fats that cause heart disease, the number one killer of Americans," said Dr. John Baxter, director of the Genomic Medicine Program at The Methodist Hospital Research Institute and co-author for the study.
"For patients taking a statin, this drug can further lower LDL cholesterol by 25 percent on top of what the statin is doing. It is also as potent in lowering triglycerides as any current medication available today," Baxter added. "It also lowers Lp(a), which is an under recognized factor that also causes atherosclerosis and is a common cause of heart attack in young people. Thus, eprotirome could be a major complement to the only current medication for this condition, niacin, which causes flushing side effects."
While statins remain the gold standard for cholesterol reduction today, they are still limited in helping patients reach strident goals set to reduce a patient's risk for heart disease and heart attack, and they can have significant side effects, Baxter added.
Results from the study show that eprotirome could be used in addition to statins to help patients who have not been able to reach their cholesterol goals, or could be used to reduce the statin dose to decrease statin side effects including muscle pain and bone loss.
About the study
The phase II clinical trial evaluated eprotirome, a liver selective thyroid hormone receptor agonist, and its ability to further reduce serum LDL cholesterol levels in statin-treated patients.
The study was a randomized, placebo-controlled, double-blind multi-center trial that lasted three months. It was designed to assess the safety and efficacy of eprotirome (KB2115) in lowering the serum concentration of LDL cholesterol and other atherogenic lipids in patients with high cholesterol who are already taking simvastatin or atorvastatin.
In all, 329 patients were screened for the study, of which 189 were randomized and included in the trial. In addition to statin treatment, they received either eprotirome 25, 50, or 100 mcg per day or placebo. Primary outcome was LDL cholesterol and secondary outcomes were changes in serum apo B, triglyceride, and Lp(a) concentrations. Safety monitoring included assessments of potential adverse thyroid hormone-like effects on the heart, bone, and pituitary.
The addition of eprotirome to statin treatment for 12 weeks resulted in placebo-adjusted reductions in serum LDL-cholesterol concentrations of -15 percent, -20 percent, and -26 percent with daily 25 mcg, 50 mcg and 100 mcg eprotirome, respectively. Similar reductions were seen in serum apo B (-14 percent, -19 percent, and -24 percent), triglycerides (-20 percent, -20 percent, and -37 percent), and Lp(a) (-17 percent, -22 percent, and -34 percent). These effects on atherogenic lipid variables were similar in magnitude to those found in a previous study where eprotirome was given as monotherapy, indicating a full additive effect on top of statins. Eprotirome therapy was clinically very well tolerated without adverse cardiac or bone or pituitary effects.
The frequency, pattern and intensity of adverse events were similar in placebo and eprotirome-treated patients.
The study was funded by Karo Bio, a Swedish pharmaceutical company that Baxter helped found in 1987.
"Our study has shown a dramatic reduction in the dangerous fats that cause heart disease, the number one killer of Americans," said Dr. John Baxter, director of the Genomic Medicine Program at The Methodist Hospital Research Institute and co-author for the study.
"For patients taking a statin, this drug can further lower LDL cholesterol by 25 percent on top of what the statin is doing. It is also as potent in lowering triglycerides as any current medication available today," Baxter added. "It also lowers Lp(a), which is an under recognized factor that also causes atherosclerosis and is a common cause of heart attack in young people. Thus, eprotirome could be a major complement to the only current medication for this condition, niacin, which causes flushing side effects."
While statins remain the gold standard for cholesterol reduction today, they are still limited in helping patients reach strident goals set to reduce a patient's risk for heart disease and heart attack, and they can have significant side effects, Baxter added.
Results from the study show that eprotirome could be used in addition to statins to help patients who have not been able to reach their cholesterol goals, or could be used to reduce the statin dose to decrease statin side effects including muscle pain and bone loss.
About the study
The phase II clinical trial evaluated eprotirome, a liver selective thyroid hormone receptor agonist, and its ability to further reduce serum LDL cholesterol levels in statin-treated patients.
The study was a randomized, placebo-controlled, double-blind multi-center trial that lasted three months. It was designed to assess the safety and efficacy of eprotirome (KB2115) in lowering the serum concentration of LDL cholesterol and other atherogenic lipids in patients with high cholesterol who are already taking simvastatin or atorvastatin.
In all, 329 patients were screened for the study, of which 189 were randomized and included in the trial. In addition to statin treatment, they received either eprotirome 25, 50, or 100 mcg per day or placebo. Primary outcome was LDL cholesterol and secondary outcomes were changes in serum apo B, triglyceride, and Lp(a) concentrations. Safety monitoring included assessments of potential adverse thyroid hormone-like effects on the heart, bone, and pituitary.
The addition of eprotirome to statin treatment for 12 weeks resulted in placebo-adjusted reductions in serum LDL-cholesterol concentrations of -15 percent, -20 percent, and -26 percent with daily 25 mcg, 50 mcg and 100 mcg eprotirome, respectively. Similar reductions were seen in serum apo B (-14 percent, -19 percent, and -24 percent), triglycerides (-20 percent, -20 percent, and -37 percent), and Lp(a) (-17 percent, -22 percent, and -34 percent). These effects on atherogenic lipid variables were similar in magnitude to those found in a previous study where eprotirome was given as monotherapy, indicating a full additive effect on top of statins. Eprotirome therapy was clinically very well tolerated without adverse cardiac or bone or pituitary effects.
The frequency, pattern and intensity of adverse events were similar in placebo and eprotirome-treated patients.
The study was funded by Karo Bio, a Swedish pharmaceutical company that Baxter helped found in 1987.
воскресенье, 10 июля 2011 г.
Employee CVD Medical, Hospital Costs Reduced By Corporate Health Program
A comprehensive health promotion program reduced cardiovascular disease-related medical and hospital costs, according to a new study.
CSX Transportation, a national company with 30,000 employees, developed the program in 2004 to address employees' high rates of cardiovascular disease when compared to national benchmarks and the associated higher healthcare costs.
Over time, the program included a variety of interventions, such as biometric screenings, nutrition and exercise health coaching, and on-site fitness centers at multiple employee locations. Researchers analyzed the impact of the program on cardiovascular disease-related medical and hospital claims, using 2006-08 data on 5,768 non-contract employees.
They found:
In employees with high cholesterol, average total cholesterol declined from 196.4 to 185.2 mg/dL; average high-density lipoprotein (HDL) cholesterol increased from 38.7 to 42.1 mg/dL. The ratio of total cholesterol to HDL declined from 5.5 to a healthier 4.9. The percentage of employees reaching low-density lipoprotein (LDL) goals increased from 48 percent to 62.4 percent.
In employees with hypertension, average blood pressure declined from 137.2/86.1 to 125.4/80.2 mm Hg. Blood pressure goal attainment increased from 42.5 percent to 67.4 percent.
In employees with diabetes, average fasting blood glucose (BG) remained unchanged, while non-fasting BG declined from 152.3 to 146.2 mg/dL.
The percentage of employees with a cardiovascular disease-related medical claim declined from 56.6 percent to 48.3 percent, and cardiovascular disease-related medical claims declined from 14.1 percent to 13.1 percent.
The percentage of employees with a cardiovascular disease-related hospital claim declined from 6 percent to 4.3 percent and cardiovascular disease-related hospital claims declined from 2.5 percent to 1.7 percent.
Abstract P303
CSX Transportation, a national company with 30,000 employees, developed the program in 2004 to address employees' high rates of cardiovascular disease when compared to national benchmarks and the associated higher healthcare costs.
Over time, the program included a variety of interventions, such as biometric screenings, nutrition and exercise health coaching, and on-site fitness centers at multiple employee locations. Researchers analyzed the impact of the program on cardiovascular disease-related medical and hospital claims, using 2006-08 data on 5,768 non-contract employees.
They found:
In employees with high cholesterol, average total cholesterol declined from 196.4 to 185.2 mg/dL; average high-density lipoprotein (HDL) cholesterol increased from 38.7 to 42.1 mg/dL. The ratio of total cholesterol to HDL declined from 5.5 to a healthier 4.9. The percentage of employees reaching low-density lipoprotein (LDL) goals increased from 48 percent to 62.4 percent.
In employees with hypertension, average blood pressure declined from 137.2/86.1 to 125.4/80.2 mm Hg. Blood pressure goal attainment increased from 42.5 percent to 67.4 percent.
In employees with diabetes, average fasting blood glucose (BG) remained unchanged, while non-fasting BG declined from 152.3 to 146.2 mg/dL.
The percentage of employees with a cardiovascular disease-related medical claim declined from 56.6 percent to 48.3 percent, and cardiovascular disease-related medical claims declined from 14.1 percent to 13.1 percent.
The percentage of employees with a cardiovascular disease-related hospital claim declined from 6 percent to 4.3 percent and cardiovascular disease-related hospital claims declined from 2.5 percent to 1.7 percent.
Abstract P303
четверг, 7 июля 2011 г.
Researcher breaks down cholesterol mystery
You may not yet have heard of chylomicrons, but a nutritional scientist at the University of Alberta believes you will
soon--especially if you care about preventing a stroke or heart attack.
Dr. Spencer Proctor says chylomicrons gather on arterial walls and may be as dangerous or more dangerous than low-density
lipoprotein (LDL) cholesterol in causing strokes and heart attacks.
"We were the first in the world to label chylomicrons remnants with florescence and visually show that these particles can
accumulate in arterial vessels," Proctor said. "Our next goal is to figure out why they get stuck and whether or not they
play a significant role in the development of coronary artery disease--our suspicion now is that they do."
Chylomicrons are metabolized balls of fat and cholesterol that enter the blood stream through the intestines after a
meal--usually within about 15 minutes after your last bite.
However, because chylomicrons are processed so quickly, when a patient gives a blood sample after fasting for 12 hours or
more, as per doctors' usual orders, chylomicron cholesterol will usually comprise just three per cent of all the cholesterol
in the sample.
LDL cholesterol is the most prevalent type of cholesterol, usually comprising about 70 per cent of all cholesterols found in
blood samples taken from patients who have fasted for 12 hours or more.
For this reason, most researchers believe LDL cholesterol, which is produced in the liver and delivered to the rest of the
body over a period of days after food is ingested, is the leading culprit among cholesterols in the development of coronary
artery disease.
However, researchers have also been at a loss to explain why 40 per cent of people who are highly vulnerable to suffering a
stroke or heart attack have low or normal LDL levels.
"That's why we believe chylomicrons and their remnants are the key to solving this problem," said Proctor, whose research is
published in the November issue of Arteriosclerosis, Thrombosis and Vascular Biology. "We believe understanding chylomicrons
and their metabolism may answer all questions about cholesterol and the role it plays in the development of diabetes,
obesity, and other cardiovascular diseases."
Using unique and specially designed imaging tools, Proctor and his colleagues tracked the formation and delivery pathways of
chylomicrons in rabbits. Their research showed that chylomicron remnants form smaller lipoproteins, which can build up more
quickly in arteries than any other type of cholesterol-carriers, including LDL.
"At the moment, not enough is known about chylomicron remnants and their pathways," Proctor said. "As a first goal, I'd like
to see a greater awareness among clinicians about the significance of chylomicrons to cardiovascular disease and how to test
their metabolism in humans."
"We know that you don't need to have raised concentrations of LDL to have high levels of chylomicrons," he added. "And it may
well be that chylomicrons could be a significant risk factor for developing heart disease and stroke."
Proctor has received funding for his research from the National Heart Foundation of Australia, the Juvenile Diabetes Research
Foundation, the Japanese Atherosclerosis Society, and a number of pharmaceutical companies.
Dr. Proctor can be reached at 780-492-4672 or spencer.proctorualberta.ca.
Contact: Ryan Smith
ryan.smithualberta.ca
780-492-0436
University of Alberta
soon--especially if you care about preventing a stroke or heart attack.
Dr. Spencer Proctor says chylomicrons gather on arterial walls and may be as dangerous or more dangerous than low-density
lipoprotein (LDL) cholesterol in causing strokes and heart attacks.
"We were the first in the world to label chylomicrons remnants with florescence and visually show that these particles can
accumulate in arterial vessels," Proctor said. "Our next goal is to figure out why they get stuck and whether or not they
play a significant role in the development of coronary artery disease--our suspicion now is that they do."
Chylomicrons are metabolized balls of fat and cholesterol that enter the blood stream through the intestines after a
meal--usually within about 15 minutes after your last bite.
However, because chylomicrons are processed so quickly, when a patient gives a blood sample after fasting for 12 hours or
more, as per doctors' usual orders, chylomicron cholesterol will usually comprise just three per cent of all the cholesterol
in the sample.
LDL cholesterol is the most prevalent type of cholesterol, usually comprising about 70 per cent of all cholesterols found in
blood samples taken from patients who have fasted for 12 hours or more.
For this reason, most researchers believe LDL cholesterol, which is produced in the liver and delivered to the rest of the
body over a period of days after food is ingested, is the leading culprit among cholesterols in the development of coronary
artery disease.
However, researchers have also been at a loss to explain why 40 per cent of people who are highly vulnerable to suffering a
stroke or heart attack have low or normal LDL levels.
"That's why we believe chylomicrons and their remnants are the key to solving this problem," said Proctor, whose research is
published in the November issue of Arteriosclerosis, Thrombosis and Vascular Biology. "We believe understanding chylomicrons
and their metabolism may answer all questions about cholesterol and the role it plays in the development of diabetes,
obesity, and other cardiovascular diseases."
Using unique and specially designed imaging tools, Proctor and his colleagues tracked the formation and delivery pathways of
chylomicrons in rabbits. Their research showed that chylomicron remnants form smaller lipoproteins, which can build up more
quickly in arteries than any other type of cholesterol-carriers, including LDL.
"At the moment, not enough is known about chylomicron remnants and their pathways," Proctor said. "As a first goal, I'd like
to see a greater awareness among clinicians about the significance of chylomicrons to cardiovascular disease and how to test
their metabolism in humans."
"We know that you don't need to have raised concentrations of LDL to have high levels of chylomicrons," he added. "And it may
well be that chylomicrons could be a significant risk factor for developing heart disease and stroke."
Proctor has received funding for his research from the National Heart Foundation of Australia, the Juvenile Diabetes Research
Foundation, the Japanese Atherosclerosis Society, and a number of pharmaceutical companies.
Dr. Proctor can be reached at 780-492-4672 or spencer.proctorualberta.ca.
Contact: Ryan Smith
ryan.smithualberta.ca
780-492-0436
University of Alberta
понедельник, 4 июля 2011 г.
Lipitor Receives FDA Approval For Five New Indications In Patients With Heart Disease
Pfizer announced today that
the U.S. Food and Drug Administration (FDA) has approved Lipitor(R)
(atorvastatin calcium) Tablets to reduce the risk of nonfatal heart
attacks, fatal and non-fatal strokes, certain types of heart surgery,
hospitalization for heart failure, and chest pain in patients with heart
disease. Lipitor is the first cholesterol-lowering medication to receive
FDA approval for the reduction of the risk of hospitalization for heart
failure.
This new approval expands the use of Lipitor to patients at high risk
for cardiovascular events because of established heart disease such as
prior heart attack, prior heart surgery, or chest pain with evidence of
clogged arteries. Previously, Lipitor was approved to reduce cardiovascular
events in patients without heart disease.
"These new indications are important since many patients who have heart
disease remain at risk for another cardiovascular event, and now these
indications broaden the means to reduce their risk," said Dr. John C.
LaRosa, president and professor of medicine at the State University of New
York Downstate Medical Center in Brooklyn, N.Y. and lead investigator for
the Treating to New Targets (TNT) trial. "The significant reduction in
cardiovascular events seen in the TNT trial can now be applied to everyday
practice and benefit people with heart disease in the United States."
The approval is based on results from the landmark TNT trial and
supported by findings from the Incremental Decrease in Endpoints through
Aggressive Lipid Lowering (IDEAL) trial. The results of these two trials
were important enough to be referenced in updated treatment guidelines
issued jointly by the American Heart Association and the American College
of Cardiology in 2006.
The five-year TNT study involved 10,000 patients with both heart
disease and elevated LDL levels. It is the longest and largest study of
Lipitor 80 mg efficacy and safety.
In this study, patients taking Lipitor 80 mg had a significant 22
percent reduction in the risk of major cardiovascular events over and above
patients taking Lipitor 10 mg. In addition, patients treated with Lipitor
80 mg had a significant 26 percent reduction in the risk of hospitalization
for heart failure.
There were more serious adverse events and discontinuations due to
adverse events with Lipitor 80 mg compared with Lipitor 10 mg. However,
there was no difference in the overall frequency of treatment-related
adverse events.
"Lipitor is the world's most extensively studied cholesterol-lowering
medication, and is supported by a large clinical trial program that
includes more than ten cardiovascular outcomes trials with over 50,000
patients across a broad spectrum of risk," said Dr. Michael Berelowitz,
Pfizer senior vice president of global medical. "Lipitor is the only statin
that offers a unique combination of proven significant cardiovascular event
reductions, impressive average LDL lowering of 39 percent to 60 percent,
and a well-established safety profile."
Lipitor is the most prescribed cholesterol-lowering therapy in the
world, with nearly 133 million patient-years of experience. Lipitor is
supported by an extensive clinical trial program involving more than 400
ongoing and completed trials with more than 80,000 patients.
Atherosclerosis is a buildup of plaque including cholesterol and other
substances in the walls of arteries. This buildup can cause arteries to
become thick and hard (known as arteriosclerosis). It can also clog
arteries, causing them to carry a reduced blood and oxygen supply to the
organs. In the heart, this is manifested as coronary heart disease, a form
of cardiovascular disease, and can result in a heart attack. In the brain,
atherosclerosis can result in a stroke.
More than 15 million Americans have a history of coronary heart
disease. This year, an estimated 300,000 Americans will have a recurrent
heart attack. The prevalence of coronary heart disease also contributes to
burdensome healthcare costs for patients as well as the nation's healthcare
system. The American Heart Association expects direct and indirect costs of
coronary heart disease to total nearly $152 billion in 2007.
Important US Prescribing Information
Lipitor is a prescription medication. It is used in patients with
multiple risk factors for heart disease such as family history, high blood
pressure, age, low HDL ("good" cholesterol) or smoking to reduce the risk
of heart attack, stroke, certain kinds of heart surgery, and chest pain.
Lipitor is used in patients with existing coronary heart disease to
reduce the risk of heart attack, stroke, certain kinds of heart surgery,
hospitalization for heart failure, and chest pain.
Lipitor is also used in patients with type 2 diabetes and at least one
other risk factor for heart disease such as high blood pressure, smoking or
complications of diabetes, including eye disease and protein in urine, to
reduce the risk of heart attack and stroke.
When diet and exercise alone are not enough, Lipitor is used along with
a low-fat diet and exercise to lower cholesterol.
Lipitor is not for everyone. It is not for those with liver problems.
And it is not for women who are nursing, pregnant or may become pregnant.
Patients taking Lipitor should tell their doctors if they feel any new
muscle pain or weakness. This could be a sign of rare but serious muscle
side effects. Patients should tell their doctors about all medications they
take. This may help avoid serious drug interactions. Doctors should do
blood tests to check liver function before and during treatment and may
adjust the dose. The most common side effects are gas, constipation,
stomach pain and heartburn. They tend to be mild and often go away.
For additional product information, visit Lipitor.
Pfizer Inc
pfizer
the U.S. Food and Drug Administration (FDA) has approved Lipitor(R)
(atorvastatin calcium) Tablets to reduce the risk of nonfatal heart
attacks, fatal and non-fatal strokes, certain types of heart surgery,
hospitalization for heart failure, and chest pain in patients with heart
disease. Lipitor is the first cholesterol-lowering medication to receive
FDA approval for the reduction of the risk of hospitalization for heart
failure.
This new approval expands the use of Lipitor to patients at high risk
for cardiovascular events because of established heart disease such as
prior heart attack, prior heart surgery, or chest pain with evidence of
clogged arteries. Previously, Lipitor was approved to reduce cardiovascular
events in patients without heart disease.
"These new indications are important since many patients who have heart
disease remain at risk for another cardiovascular event, and now these
indications broaden the means to reduce their risk," said Dr. John C.
LaRosa, president and professor of medicine at the State University of New
York Downstate Medical Center in Brooklyn, N.Y. and lead investigator for
the Treating to New Targets (TNT) trial. "The significant reduction in
cardiovascular events seen in the TNT trial can now be applied to everyday
practice and benefit people with heart disease in the United States."
The approval is based on results from the landmark TNT trial and
supported by findings from the Incremental Decrease in Endpoints through
Aggressive Lipid Lowering (IDEAL) trial. The results of these two trials
were important enough to be referenced in updated treatment guidelines
issued jointly by the American Heart Association and the American College
of Cardiology in 2006.
The five-year TNT study involved 10,000 patients with both heart
disease and elevated LDL levels. It is the longest and largest study of
Lipitor 80 mg efficacy and safety.
In this study, patients taking Lipitor 80 mg had a significant 22
percent reduction in the risk of major cardiovascular events over and above
patients taking Lipitor 10 mg. In addition, patients treated with Lipitor
80 mg had a significant 26 percent reduction in the risk of hospitalization
for heart failure.
There were more serious adverse events and discontinuations due to
adverse events with Lipitor 80 mg compared with Lipitor 10 mg. However,
there was no difference in the overall frequency of treatment-related
adverse events.
"Lipitor is the world's most extensively studied cholesterol-lowering
medication, and is supported by a large clinical trial program that
includes more than ten cardiovascular outcomes trials with over 50,000
patients across a broad spectrum of risk," said Dr. Michael Berelowitz,
Pfizer senior vice president of global medical. "Lipitor is the only statin
that offers a unique combination of proven significant cardiovascular event
reductions, impressive average LDL lowering of 39 percent to 60 percent,
and a well-established safety profile."
Lipitor is the most prescribed cholesterol-lowering therapy in the
world, with nearly 133 million patient-years of experience. Lipitor is
supported by an extensive clinical trial program involving more than 400
ongoing and completed trials with more than 80,000 patients.
Atherosclerosis is a buildup of plaque including cholesterol and other
substances in the walls of arteries. This buildup can cause arteries to
become thick and hard (known as arteriosclerosis). It can also clog
arteries, causing them to carry a reduced blood and oxygen supply to the
organs. In the heart, this is manifested as coronary heart disease, a form
of cardiovascular disease, and can result in a heart attack. In the brain,
atherosclerosis can result in a stroke.
More than 15 million Americans have a history of coronary heart
disease. This year, an estimated 300,000 Americans will have a recurrent
heart attack. The prevalence of coronary heart disease also contributes to
burdensome healthcare costs for patients as well as the nation's healthcare
system. The American Heart Association expects direct and indirect costs of
coronary heart disease to total nearly $152 billion in 2007.
Important US Prescribing Information
Lipitor is a prescription medication. It is used in patients with
multiple risk factors for heart disease such as family history, high blood
pressure, age, low HDL ("good" cholesterol) or smoking to reduce the risk
of heart attack, stroke, certain kinds of heart surgery, and chest pain.
Lipitor is used in patients with existing coronary heart disease to
reduce the risk of heart attack, stroke, certain kinds of heart surgery,
hospitalization for heart failure, and chest pain.
Lipitor is also used in patients with type 2 diabetes and at least one
other risk factor for heart disease such as high blood pressure, smoking or
complications of diabetes, including eye disease and protein in urine, to
reduce the risk of heart attack and stroke.
When diet and exercise alone are not enough, Lipitor is used along with
a low-fat diet and exercise to lower cholesterol.
Lipitor is not for everyone. It is not for those with liver problems.
And it is not for women who are nursing, pregnant or may become pregnant.
Patients taking Lipitor should tell their doctors if they feel any new
muscle pain or weakness. This could be a sign of rare but serious muscle
side effects. Patients should tell their doctors about all medications they
take. This may help avoid serious drug interactions. Doctors should do
blood tests to check liver function before and during treatment and may
adjust the dose. The most common side effects are gas, constipation,
stomach pain and heartburn. They tend to be mild and often go away.
For additional product information, visit Lipitor.
Pfizer Inc
pfizer
пятница, 1 июля 2011 г.
Bad Cholesterol In Patients With Type II Diabetes Studied In Mayo Clinic Proceedings
Results from a clinical study conducted in 1,229 patients with type II diabetes mellitus and high cholesterol showed that VYTORIN® (ezetimibe/simvastatin) provided superior reduction in LDL "bad" cholesterol compared to Lipitor® (atorvastatin) at the dose comparisons studied, according to data published in the December 2006 issue of Mayo Clinic Proceedings. The primary efficacy endpoint was the percent change from baseline in LDL cholesterol at the end of the six-week treatment period.
VYTORIN, which contains ezetimibe and simvastatin, is the first and only product approved to treat the two sources of cholesterol by inhibiting the production of cholesterol in the liver and blocking the absorption of cholesterol in the intestine, including cholesterol from food. VYTORIN is marketed as INEGY in many countries outside the U.S.
VYTORIN 10/20 mg demonstrated a 53.6 mean percent reduction from baseline in LDL cholesterol as compared to a 38.3 percent reduction observed with Lipitor 10 mg and a 44.6 percent reduction with Lipitor 20 mg - the recommended usual starting doses of both agents. At the next highest doses, VYTORIN 10/40 mg decreased LDL cholesterol significantly more than Lipitor 40 mg - 57.6 percent compared to 50.9 percent, respectively, (p
Additional results from the study demonstrated that VYTORIN (10/20 and 10/40 mg) increased HDL "good" cholesterol by 8.0 and 6.3 percent, respectively, as compared to the HDL increases of 4.3 (p
VYTORIN, which contains ezetimibe and simvastatin, is the first and only product approved to treat the two sources of cholesterol by inhibiting the production of cholesterol in the liver and blocking the absorption of cholesterol in the intestine, including cholesterol from food. VYTORIN is marketed as INEGY in many countries outside the U.S.
VYTORIN 10/20 mg demonstrated a 53.6 mean percent reduction from baseline in LDL cholesterol as compared to a 38.3 percent reduction observed with Lipitor 10 mg and a 44.6 percent reduction with Lipitor 20 mg - the recommended usual starting doses of both agents. At the next highest doses, VYTORIN 10/40 mg decreased LDL cholesterol significantly more than Lipitor 40 mg - 57.6 percent compared to 50.9 percent, respectively, (p
Additional results from the study demonstrated that VYTORIN (10/20 and 10/40 mg) increased HDL "good" cholesterol by 8.0 and 6.3 percent, respectively, as compared to the HDL increases of 4.3 (p
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