The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Richard Wray - One of the best experts on this subject based on the ideXlab platform.
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Drug Treatment of Combined Hyperlipidemia
American Journal of Cardiovascular Drugs, 2001Co-Authors: Anthony S. Wierzbicki, Dimitri P. Mikhailidis, Richard WrayAbstract:Combined Hyperlipidemia is increasing in frequency and is the most common lipid disorder associated with obesity, insulin resistance and diabetes mellitus. It is associated with other features of the metabolic syndrome including hypertension, hyperuricemia, hyperinsulinemia and highly atherogenic subfractions of lipoprotein remnant particles including small dense low density lipoprotein-cholesterol. This review examines the mechanisms by which combined Hyperlipidemia arises and the various drugs including fibric acid derivatives, hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, and nicotinic acid which can be used either as monotherapy or in combination to manage it and to improve prognosis from atherosclerotic disease in diabetes mellitus, insulin resistant states and primary combined Hyperlipidemia. The therapeutic approach to combined Hyperlipidemia involves determination of whether the cause is hepatocyte damage or metabolic derangements. Combined Hyperlipidemia due to hepatocyte damage should be treated by attention to the primary cause. In the case of metabolic dysfunction because of imbalance in glucose and fat metabolism, therapy of diabetes mellitus and obesity should be optimised prior to commencement of lipid lowering drugs. Both fibric acid derivatives and HMG-CoA reductase inhibitors can be used in the treatment of combined Hyperlipidemia with fibric acid derivatives having greater effects on triglycerides and HMG-CoA reductase inhibitors on LDL-C though both have effects on the other cardiovascular risk factors. There is some evidence of benefit with both interventions in mild combined Hyperlipidemias and large scale trials are underway. Fibric acid derivatives and HMG-CoA reductase inhibitor therapy can be combined with care, provided that gemfibrozil is avoided, fibric acid derivatives are given in the mornings and shorter half -life HMG-CoA reductase inhibitors are used at night. Combined Hyperlipidemia emergencies occur with predominant hypertriglyceridemia in pregnancy or as a cause of pancreatitis. Therapy in the former should aim to reduce chylomicron production by a low fat diet and intervention to suppress VLDL-C secretion using omega-3 fatty acids. In the latter case, fluid therapy alone and medium chain plasma triglyceride infusions usually reduce levels satisfactorily though apheresis may be required. Blood glucose levels also need aggressive management in these conditions. Combined Hyperlipidemia is likely to become an increasing problem with the increase in the prevalence of obesity and diabetes mellitus and needs aggressive management to reduce cardiovascular risk.
Guy D Eslick - One of the best experts on this subject based on the ideXlab platform.
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benefits of fish oil supplementation in Hyperlipidemia a systematic review and meta analysis
International Journal of Cardiology, 2009Co-Authors: Guy D Eslick, Peter R C Howe, Caroline A Smith, Ros Priest, Alan BensoussanAbstract:Abstract Background Fish oils have been widely reported as a useful supplement to reduce fasting blood triglyceride levels in individuals with Hyperlipidemia. We performed an updated meta-analysis to quantitatively evaluate all the randomized trials of fish oils in hyperlipidemic subjects. Methods We conducted a systematic literature search using several electronic databases supplemented by manual searches of published reference lists, review articles and conference abstracts. We included all placebo-controlled randomized trials of parallel design that evaluated any of the main blood lipid outcomes: total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol or triglycerides (TG). Data were pooled using DerSimonian–Laird's random effects model. Results The final analysis comprised of 47 studies in otherwise untreated subjects showed that taking fish oils (weighted average daily intake of 3.25 g of EPA and/or DHA) produced a clinically significant reduction of TG (− 0.34 mmol/L, 95% CI: − 0.41 to − 0.27), no change in total cholesterol (− 0.01 mmol/L, 95% CI: − 0.03 to 0.01) and very slight increases in HDL (0.01 mmol/L, 95% CI: 0.00 to 0.02) and LDL cholesterol (0.06 mmol/L, 95% CI: 0.03 to 0.09). The reduction of TG correlated with both EPA + DHA intake and initial TG level. Conclusion Fish oil supplementation produces a clinically significant dose-dependent reduction of fasting blood TG but not total, HDL or LDL cholesterol in hyperlipidemic subjects.
Alan Bensoussan - One of the best experts on this subject based on the ideXlab platform.
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benefits of fish oil supplementation in Hyperlipidemia a systematic review and meta analysis
International Journal of Cardiology, 2009Co-Authors: Guy D Eslick, Peter R C Howe, Caroline A Smith, Ros Priest, Alan BensoussanAbstract:Abstract Background Fish oils have been widely reported as a useful supplement to reduce fasting blood triglyceride levels in individuals with Hyperlipidemia. We performed an updated meta-analysis to quantitatively evaluate all the randomized trials of fish oils in hyperlipidemic subjects. Methods We conducted a systematic literature search using several electronic databases supplemented by manual searches of published reference lists, review articles and conference abstracts. We included all placebo-controlled randomized trials of parallel design that evaluated any of the main blood lipid outcomes: total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol or triglycerides (TG). Data were pooled using DerSimonian–Laird's random effects model. Results The final analysis comprised of 47 studies in otherwise untreated subjects showed that taking fish oils (weighted average daily intake of 3.25 g of EPA and/or DHA) produced a clinically significant reduction of TG (− 0.34 mmol/L, 95% CI: − 0.41 to − 0.27), no change in total cholesterol (− 0.01 mmol/L, 95% CI: − 0.03 to 0.01) and very slight increases in HDL (0.01 mmol/L, 95% CI: 0.00 to 0.02) and LDL cholesterol (0.06 mmol/L, 95% CI: 0.03 to 0.09). The reduction of TG correlated with both EPA + DHA intake and initial TG level. Conclusion Fish oil supplementation produces a clinically significant dose-dependent reduction of fasting blood TG but not total, HDL or LDL cholesterol in hyperlipidemic subjects.
Anthony S. Wierzbicki - One of the best experts on this subject based on the ideXlab platform.
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Drug Treatment of Combined Hyperlipidemia
American Journal of Cardiovascular Drugs, 2001Co-Authors: Anthony S. Wierzbicki, Dimitri P. Mikhailidis, Richard WrayAbstract:Combined Hyperlipidemia is increasing in frequency and is the most common lipid disorder associated with obesity, insulin resistance and diabetes mellitus. It is associated with other features of the metabolic syndrome including hypertension, hyperuricemia, hyperinsulinemia and highly atherogenic subfractions of lipoprotein remnant particles including small dense low density lipoprotein-cholesterol. This review examines the mechanisms by which combined Hyperlipidemia arises and the various drugs including fibric acid derivatives, hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, and nicotinic acid which can be used either as monotherapy or in combination to manage it and to improve prognosis from atherosclerotic disease in diabetes mellitus, insulin resistant states and primary combined Hyperlipidemia. The therapeutic approach to combined Hyperlipidemia involves determination of whether the cause is hepatocyte damage or metabolic derangements. Combined Hyperlipidemia due to hepatocyte damage should be treated by attention to the primary cause. In the case of metabolic dysfunction because of imbalance in glucose and fat metabolism, therapy of diabetes mellitus and obesity should be optimised prior to commencement of lipid lowering drugs. Both fibric acid derivatives and HMG-CoA reductase inhibitors can be used in the treatment of combined Hyperlipidemia with fibric acid derivatives having greater effects on triglycerides and HMG-CoA reductase inhibitors on LDL-C though both have effects on the other cardiovascular risk factors. There is some evidence of benefit with both interventions in mild combined Hyperlipidemias and large scale trials are underway. Fibric acid derivatives and HMG-CoA reductase inhibitor therapy can be combined with care, provided that gemfibrozil is avoided, fibric acid derivatives are given in the mornings and shorter half -life HMG-CoA reductase inhibitors are used at night. Combined Hyperlipidemia emergencies occur with predominant hypertriglyceridemia in pregnancy or as a cause of pancreatitis. Therapy in the former should aim to reduce chylomicron production by a low fat diet and intervention to suppress VLDL-C secretion using omega-3 fatty acids. In the latter case, fluid therapy alone and medium chain plasma triglyceride infusions usually reduce levels satisfactorily though apheresis may be required. Blood glucose levels also need aggressive management in these conditions. Combined Hyperlipidemia is likely to become an increasing problem with the increase in the prevalence of obesity and diabetes mellitus and needs aggressive management to reduce cardiovascular risk.
Yansheng Du - One of the best experts on this subject based on the ideXlab platform.
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pu erh tea aqueous extracts lower atherosclerotic risk factors in a rat Hyperlipidemia model
Experimental Gerontology, 2009Co-Authors: Wanfang Shao, Rong Xiao, Kunlong Xu, Brian H Johnstone, Yansheng DuAbstract:Pu-erh tea is believed to possess many beneficial health effects since it is a natural source of cardioprotective lipid lowering and antioxidant compounds, although, the major constituents putatively responsible for these beneficial effects remain unknown. In this study, we examined the effects of two commonly consumed forms of Pu-erh tea, fermented and unfermented, on weight gain, serum levels of lipids and lipoprotein, lipid oxidation, and blood antioxidant enzymes in a rat Hyperlipidemia model. Hyperlipidemic rats were treated with water extracts of either 0.5, 1.5 or 3.0 mg/kg fermented or unfermented Pu-erh tea. Serum low density lipoprotein-cholesterol (LDL-C) and triglyceride levels were significantly lowered by tea extract compared to the control group. (p < 0.05) and in most cases were indistinguishable from rats fed normal chow, basal diet. Conversely, levels of high density lipoprotein-cholesterol (HDL-C) were elevated in the groups given daily doses of tea extract (p < 0.05). Compared to the hyperlipidemic control group, activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in serum were significantly elevated in Pu-erh tea-treated groups while levels of malondiadehyde (a byproduct of lipid peroxidation) decreased in the same groups. These effects were most pronounced in the groups treated with the highest dose of fermented Pu-erh tea extract. Our results suggest that Pu-erh tea exerts strong antioxidative and lipid-lowering effects and therefore can be used to reduce the risk of cardiovascular disorders.