Joint British Society Guidelines

Data collected from 1988 to 1991 by the WHO revealed that the death rate from CVD in the United Kingdom was the highest in the world at that time. In the United Kingdom, CHD is the most common cause of premature death (12). In the year 2000, CHD was responsible for one in four male deaths and one in six female deaths totaling around 125,000 deaths. The National Health Service estimated that costs related to CHD are 1.6 billion per year with only 1 spent on primary prevention of CVD. The overall...

Info

Generation of the lipid triad. Adapted from Ginsberg (40). Fig. 3. Generation of the lipid triad. Adapted from Ginsberg (40). (Fig. 3). CETP activity is also reportedly enhanced by an elevation in FFA concentration (9,13). The result is that the LDL and HDL particles become relatively TG rich and cholesterol poor. The TGs in these particles can be hydrolyzed by hepatic lipase to form smaller, denser particles. Small, dense LDL particles are believed to have enhanced atherogenicity for...

Chd

Corneal opacification, hemolytic anemia, progressive renal insufficiency AD, autosomal dominant AR, autosomal recessive CETP, cholesteryl ester transfer protein CHD, coronary heart disease HDL, high-density lipoprotein LCAT, lecithin cholesterol acyttransferase LDL, low-density lipoprotein VLDL, very low density lipoprotein. inability to hydrolyze triglycerides in chylomicrons, and consequent massive hyper-chylomicronemia. These disorders are autosomal recessive and rare (approximately 1 in 1...

Contemporary Cardiology

Therapeutic Lipidology, edited by Michael H. Davidson md, facc, facp, Peter P. Toth md, PhD, faap, FICA, Faha, FCCP, facc, and Kevin C. Maki, PhD, 2007 Current Concepts in Cardiology Cardiac Rehabilitation, edited by William E. Kraus, md, facc, facsm, and StavenJ. Keteyian, PhD, 2007 Management of Acute Pulmonary Embolism, edited by Stavros V. Konstantinides, md, 2007 Stem Cells and Myocardial Regeneration, edited by Marc S. Penn, md, PhD, 2007 Essential Echocardiography A Practical Handbook...

Management of CVD Risk Factors Behavioral Risk Factors

Behavioral risk factors including diet, activity, and smoking are addressed in the new guidelines, which also suggest that recent surveys identified a significant gap between the recommendations provided and the advice given out by physicians in routine clinical practice (3). ESC guideline recommendations in these areas closely follow evidence-based practice guidelines as outlined in all guidelines referenced in this chapter therefore, these will not be reviewed. Prior to the initiation of any...

Familial Hyperalphalipoproteinemia

Familial hyperalphalipoproteinemia is defined as an inherited condition of HDL-C level greater than the 90th percentile without a known secondary cause. HDL-C in these families appears to be associated with lower risk for CHD and increased longevity. Other than CETP, additional genes that cause or contribute to this phenotype are not known. An understanding of the genetics of this syndrome would advance the scientific field and provide new targets for the development of therapeutics for HDL.

Lifestyle management for atherogenic dyslipidemia

A twofold approach is recommended for the management of dyslipidemia associated with IR (7). The first is to reduce the underlying lifestyle factors that contribute to the development of the insulin-resistant state, particularly obesity and physical inactivity. The second is to treat the individual lipid and nonlipid risk factors associated with IR. The NCEP ATP III has emphasized lifestyle changes as the first step in the management of IR and the related risk factors, including atherogenic...

Apolipoprotein classification

Although lipoproteins are classified based on their density that is determined by their combination of components, their functional uniqueness is dependent on the apolipoproteins that they carry. The apolipoproteins play a critical role in the recognition of lipoproteins as they serve as receptor ligands and enzyme cofactors. The Fig. 3. Lipoprotein composition as percent of mass (90,91). apolipoproteins are typically classified by an alphabetical designation (A through E) with a Roman numeral...

Pathogenesis of Phase 1 Endothelial Dysfunction

Glycation Inhibitor

The endothelium is a cellular monolayer that lines the blood vessels, separating the blood from the vascular media, and endothelial dysfunction is the first pathogenic sign in atherogenesis (Fig. 8) and initiates Phase 1 development (38). Endothelial cells perform both autocrine and paracrine functions, and by secreting nitric oxide (NO), they can signal for downregulation of cell adhesion molecules (CAMs), prevent vasoconstriction, shift the balance from thrombosis to fibrinolysis, prevent...

Contributors

Badimon, phD Cardiovascular Biology Research Laboratory, Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY Harold Bays, md, facp L-MARC Research Center, Louisville, KY Michael B. Boffa, msc, phD Department of Biochemistry, Queen's University, Kingston, Ontario, Canada Lynne T. Braun, phD, rn, cnp Preventive Cardiology Center, Heart Center for Women, Rush University, College of Nursing, Chicago, IL Brian G. Choi, md, mba Cardiovascular...

Humana Press Totowa New Jersey

2007 Humana Press Inc. 999 Riverview Drive, Suite 208 Totowa, New Jersey 07512 www.humanapress.com All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. The content and opinions expressed in this book are the sole work of the authors and editors, who have warranted due diligence in the...

Nejm

JACC. 2001 38(5) 1302-6. Caslake et al. (220f Glasgow case-control Winkler et al. Khuseyinova et al. (260f Ulm case-control Iribarren et al. (262f CARDIA nested CHD Control Presence of CHD T2DM Control Presence of CHD CHD Control Presence of CHD case-control CHD Control Presence of CHD a Increase of Lp-PLA2 per 1 standard deviation (SD) in multivariable analyses including CRP b Tertile analysis, multivariable including CRP c Quartile analysis, multivariable adjustment d...

References

Genetic dyslipoproteinemias role of lipoprotein lipase and apolipoprotein C-II. Curr Opin Lipidol 3 186-195. 2. Mahley, R.W., Huang, Y., and Rall, S.C.J. 1999. Pathogenesis of type III hyperlipoproteinemia (dysbetalipoproteinemia) questions, quandaries, and paradoxes. J Lipid Res 40 1933-1949. 3. Grundy, S.M., Chait, A., and Brunzell, J.D. 1987. Familial combined hyperlipidemia workshop. Arteriosclerosis 7 203-207. 4. Shoulders, C.C., Jones, E.L., and Naoumova, R.P....

Intensification of efforts to lower ldlc as a means of achieving the nonhdlc goal

Statins are recommended as first-line therapy for patients with elevated LDL-C. However, statins also markedly reduce concentrations of both TG and TG-rich lipopro-teins in hypertriglyceridemic subjects (26,27). The hypotriglyceridemic effects of statins have been widely underappreciated, largely because few studies of statin therapy had been undertaken in hypertriglyceridemic subjects until recently. TG-lowering with statins is modest in normotriglyceridemic subjects, but much more pronounced...

Inherited Syndromes of Low LDLC Abetalipoproteinemia

Abetalipoproteinemia is a rare autosomal recessive disease caused by mutations in the gene encoding microsomal transfer protein (MTP) (11), a protein that transfers lipids to nascent chylomicrons and VLDL in the intestine and liver, respectively. Plasma levels of cholesterol and triglyceride are extremely low in this disorder, and no chylomicrons, VLDL, LDL, or apoB are detectable in plasma (12). Obligate heterozygotes have normal plasma lipid and apoB levels. Abetalipoproteinemia usually...

Phase 2 Reversal Lipid Efflux

HDL also prevents LDL accumulation in the vessel wall by two principal mechanisms prevention of LDL oxidation and CAM downregulation. HDL hydrolyzes oxidized LDL, preventing LDL absorption via SRA and CD36 70 , and HDL also downregulates endothelial CAMs that could prevent monocyte entry into the vessel wall 71 . Not only does HDL have a high antioxidant content, but it also contains several enzymes that prevent LDL oxidation or degrade bioactive products of oxidized LDLs. HDL carries...