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1.
Nutrients ; 16(13)2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38999875

RESUMEN

Excess body weight in pediatric patients and the resulting dyslipidemia, if left untreated, are a serious risk factor for cardiovascular disease in young adults. Despite this, there is still no effective and validated nutritional strategy for the treatment of overweight/obesity and comorbid dyslipidemia in children and adolescents. A low-glycemic index (LGI) diet may be recommended, but evidence for its effectiveness in the pediatric population is limited. The aim of this study was to evaluate the effectiveness of nutritional intervention in children and adolescents with excess body weight and dyslipidemia. The study was conducted in patients aged 8-16 with overweight or obesity and lipid disorders (n = 64), of which 40 participants who completed the entire 8-week study were included in the analysis. Patients were randomly selected and allocated to one of the two dietary groups: the LGI diet or the standard therapy (ST) diet. Both diets were based on the principal recommendation of Cardiovascular Health Integrated Lifestyle Diet-2 (CHILD-2). This study showed that both LGI and ST diets were equally beneficial in reducing body weight, body fat, blood pressure, total cholesterol (TC), and triglyceride (TG) levels. The LGI diet, compared to the ST diet, was less effective in reducing blood TG levels but more effective in reducing diastolic blood pressure (DBP). Therefore, the choice of the type of diet in the treatment of children and adolescents with excess body weight and dyslipidemia may be individual. However, it should be based on the recommendation of CHILD-2. Further long-term, larger-scale studies are needed.


Asunto(s)
Dislipidemias , Índice Glucémico , Humanos , Adolescente , Niño , Masculino , Femenino , Dislipidemias/dietoterapia , Dislipidemias/sangre , Dislipidemias/terapia , Peso Corporal , Sobrepeso/dietoterapia , Sobrepeso/terapia , Presión Sanguínea , Obesidad Infantil/dietoterapia , Obesidad Infantil/terapia , Triglicéridos/sangre
2.
Blood Press ; 33(1): 2371863, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38949789

RESUMEN

PURPOSE: In 2022 hypertensive disease was the second cause of death in Croatia. The crude prevalence of hypertension is increasing and still majority of hypertensive patients did not reach blood pressure and cholesterol goals Low awareness, and small number of treated and controlled patients point on poor adherence and even worse clinical inertia. MATERIALS AND METHODS: Croatian Hypertension League (CHL) has started the permanent public health action Hunting the Silent Killer aiming to increase health literacy. In 2023 we decided to intensify program with two missions - '70/26', and 'Do you know what is your number?' aiming to achieve target values in 70% and in 50% of patients treated for hypertension and dyslipidaemia, respectively, by 2026. For the health care workers, the program will primarily involve digital education, and 'School of Communication in Hypertension'. In the second arm of the program, we will advise patients and general population to visit our educational website with important and useful information on how to improve bad lifestyle, how to proper measure blood pressure, why is it important to sustain in taking drugs etc. In 2026, the CHL will organise field research to assess the success of programs using the same methodology as we used in previous EH-UH studies. CONCLUSION: We will monitor and analyse trends in the management and control of patients treated for hypertension and dyslipidaemia. This will enable us to make an evidence-based conclusion how successful we were in increasing health literacy.


Hypertension is the most compelling cause of death in Croatia with increasing prevalence.Still 50.1% of treated hypertensive patients and more than 70% of patients with dyslipidaemia in Croatia are uncontrolled.Programs 70/26 and Do you know your number aimed to achieve 70% and 50% control of hypertensive and dyslipidaemia patients, respectively, by 2026.To accomplish these goals, health literacy of healthcare workers, patients, and general population we will try to improve mostly using digital education and by organising schools of communication.


Asunto(s)
Dislipidemias , Alfabetización en Salud , Hipertensión , Humanos , Croacia , Dislipidemias/tratamiento farmacológico , Dislipidemias/epidemiología , Dislipidemias/terapia , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Presión Sanguínea/efectos de los fármacos , Masculino , Femenino
3.
Arch Iran Med ; 27(6): 313-322, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38855801

RESUMEN

BACKGROUND: Cardiovascular disease (CVD) is a major global health concern, the leading cause of death and disability. Thus, preventive interventions targeting modifiable risk factors are essential. Mobile-health technologies have emerged as promising tools for improving prevention by modifying risk factors. We created the "Green Heart" mobile app to help coronary artery disease (CAD) patients control their risk factors. The app has three modules: smoking cessation, dyslipidemia (DLP) control, and blood pressure (BP) management. This study evaluated the app's performance in monitoring hypertension (HTN) and DLP among known CAD cases. METHODS: A randomized controlled trial enrolled 1590 CAD subjects, including 1114 hypertensive patients and 1488 subjects with DLP, and assigned them randomly to paper-based education or application-based groups. RESULTS: Regarding HTN, after 6 months, we finally analyzed 545 and 546 hypertensive patients, assigned to the conventional and app groups, respectively. Patients in the app group were more likely to have their BP managed successfully (88.6% vs. 78.5%; P<0.001). The app group showed higher odds of successful BP management (odds ratio [OR]: 2.13; 95% CI: 1.51 - 3.03). Regarding DLP, we analyzed 728 patients in the conventional and 714 patients in the app group. A higher percentage of patients in the app group (24.8%) had low-density lipoprotein cholesterol (LDL-C) levels less than 70 mg/dL (16.1%; P<0.001). The app group showed higher odds of reducing LDL-C (OR: 1.72; 95% CI: 1.32-2.26). CONCLUSION: We found that using the Green Heart app in the self-monitoring setting significantly improved BP and DLP management across the study population.


Asunto(s)
Dislipidemias , Hipertensión , Aplicaciones Móviles , Automanejo , Teléfono Inteligente , Humanos , Masculino , Hipertensión/terapia , Hipertensión/prevención & control , Dislipidemias/terapia , Femenino , Persona de Mediana Edad , Anciano , Automanejo/métodos , Enfermedad de la Arteria Coronaria/terapia , Enfermedad de la Arteria Coronaria/prevención & control , Cese del Hábito de Fumar/métodos , Presión Sanguínea , Irán , Educación del Paciente como Asunto/métodos , Adulto , Telemedicina
4.
Am J Clin Dermatol ; 25(4): 527-540, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38748391

RESUMEN

Epidemiological data demonstrate strong associations between psoriasis and metabolic comorbidities, including obesity, hypertension, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease. The presence of metabolic comorbidities significantly influences the selection and effectiveness of pharmacological treatments. Some drugs should be prescribed with caution in patients with metabolic comorbidities because of an increased risk of adverse events, while others could have a reduced effectiveness. The aim of this narrative review is to highlight the challenges that healthcare professionals may face regarding the management of psoriasis in patients with metabolic comorbidities. In the first part of the article, the epidemiological association between psoriasis and metabolic comorbidities and their pathogenetic mechanisms is summarized. The second part describes the efficacy and safety profile of conventional and biologic drugs in patients with selected metabolic comorbidities including obesity, non-alcoholic fatty liver disease/hepatic steatosis, and diabetes. Finally, the role of pharmacological and non-pharmacological interventions, such as diet, alcohol abstinence, physical activity, and smoking avoidance is discussed. In conclusion, the choice of the best approach to manage patients with psoriasis with metabolic comorbidities should encompass both tailored pharmacological and individualized non-pharmacological interventions.


Asunto(s)
Enfermedad del Hígado Graso no Alcohólico , Psoriasis , Humanos , Psoriasis/complicaciones , Psoriasis/tratamiento farmacológico , Psoriasis/terapia , Psoriasis/epidemiología , Enfermedad del Hígado Graso no Alcohólico/terapia , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Enfermedad del Hígado Graso no Alcohólico/tratamiento farmacológico , Comorbilidad , Obesidad/complicaciones , Obesidad/epidemiología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/terapia , Fármacos Dermatológicos/uso terapéutico , Productos Biológicos/uso terapéutico , Enfermedades Metabólicas/terapia , Enfermedades Metabólicas/epidemiología , Dislipidemias/epidemiología , Dislipidemias/tratamiento farmacológico , Dislipidemias/terapia
5.
J Am Heart Assoc ; 13(10): e033328, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38757455

RESUMEN

BACKGROUND: Mobile health technology's impact on cardiovascular risk factor control is not fully understood. This study evaluates the association between interaction with a mobile health application and change in cardiovascular risk factors. METHODS AND RESULTS: Participants with hypertension with or without dyslipidemia enrolled in a workplace-deployed mobile health application-based cardiovascular risk self-management program between January 2018 and December 2022. Retrospective evaluation explored the influence of application engagement on change in blood pressure (BP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and weight. Multiple regression analyses examined the influence of guideline-based, nonpharmacological lifestyle-based digital coaching on outcomes adjusting for confounders. Of 102 475 participants, 49.1% were women. Median age was 53 (interquartile range, 43-61) years, BP was 134 (interquartile range, 124-144)/84 (interquartile range, 78-91) mm Hg, TC was 183 (interquartile range, 155-212) mg/dL, LDL-C was 106 (82-131) mg/dL, and body mass index was 30 (26-35) kg/m2. At 2 years, participants with baseline systolic BP ≥140 mm Hg reduced systolic BP by 18.6 (SEM, 0.3) mm Hg. At follow up, participants with baseline TC ≥240 mg/dL reduced TC by 65.7 (SEM, 4.6) mg/dL, participants with baseline LDL-C≥160 mg/dL reduced LDL-C by 66.6 (SEM, 6.2) mg/dL, and participants with baseline body mass index ≥30 kg/m2 lost 12.0 (SEM, 0.3) pounds, or 5.1% of body weight. Interaction with digital coaching was associated with greater reduction in all outcomes. CONCLUSIONS: A mobile health application-based cardiovascular risk self-management program was associated with favorable reductions in BP, TC, LDL-C, and weight, highlighting the potential use of this technology in comprehensive cardiovascular risk factor control.


Asunto(s)
Enfermedades Cardiovasculares , Factores de Riesgo de Enfermedad Cardiaca , Automanejo , Telemedicina , Humanos , Femenino , Masculino , Persona de Mediana Edad , Automanejo/métodos , Adulto , Estudios Retrospectivos , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/sangre , Dislipidemias/sangre , Dislipidemias/diagnóstico , Dislipidemias/terapia , Dislipidemias/epidemiología , Aplicaciones Móviles , Hipertensión/fisiopatología , Hipertensión/terapia , Presión Sanguínea/fisiología , LDL-Colesterol/sangre , Conducta de Reducción del Riesgo
6.
Arch Cardiovasc Dis ; 117(5): 358-378, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38762344

RESUMEN

Low-density lipoprotein cholesterol has been established as a powerful cardiovascular risk factor; its reduction provides a clinical benefit in primary cardiovascular prevention, irrespective of the characteristics of the patients treated. It is useful to tailor low-density lipoprotein cholesterol targets according to the magnitude of cardiovascular risk (low, high or very high) in order to reduce the cardiovascular risk as fully as possible. In order to provide a uniform approach, it is necessary to propose recommendations for good practice, defining strategies for reducing low-density lipoprotein cholesterol. It is also necessary to know their merits, to analyse their practical limits and to propose adaptations, taking into account limitations and national specifics. This position paper aims to analyse the contribution and limits, as well as the adaptation to French practice, of 2019 and 2021 European Society of Cardiology recommendations for the management of lipid variables and cardiovascular prevention.


Asunto(s)
Biomarcadores , Enfermedades Cardiovasculares , LDL-Colesterol , Consenso , Dislipidemias , Factores de Riesgo de Enfermedad Cardiaca , Prevención Primaria , Humanos , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/sangre , Biomarcadores/sangre , LDL-Colesterol/sangre , Dislipidemias/sangre , Dislipidemias/diagnóstico , Dislipidemias/terapia , Dislipidemias/tratamiento farmacológico , Dislipidemias/epidemiología , Medición de Riesgo , Hipolipemiantes/uso terapéutico , Resultado del Tratamiento , Francia , Cardiología/normas
8.
Indian Heart J ; 76 Suppl 1: S73-S74, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38599728

RESUMEN

Evidence from the existing literature suggests that exercise has positive effects for prevention and treatment of cardiovascular diseases by reducing risk factors such as elevated blood lipids. Based on clinical and observational clinical trials, it is well established that increased physical activity and regular exercise has a favourable impact on blood lipids and lipoprotein profiles. Exercise training significantly decreases blood triglycerides concentration and increases high density lipoprotein cholesterol levels. Though the Indian data depicting the effect of exercise on lipids is scarce, exercise directly improves "atherogenic dyslipidaemia" which is frequently present among Indians i.e. HDL-C is increased, TG is reduced and LDL-C particle size is improved. While drug therapy is key to the treatment of dyslipidaemia, lifestyle alterations such as exercise should continue to be actively promoted and encouraged by clinicians. Exercise is a low cost, non pharmacological therapeutic lifestyle change that is of value to lipid metabolism and cardiovascular fitness.


Asunto(s)
Dislipidemias , Ejercicio Físico , Humanos , HDL-Colesterol , Dislipidemias/terapia , Lípidos , Lipoproteínas , Triglicéridos , Ensayos Clínicos como Asunto , Estudios Observacionales como Asunto
9.
J Atheroscler Thromb ; 31(5): 501-519, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38538336

RESUMEN

Transitional medicine refers to the seamless continuity of medical care for patients with childhood-onset diseases as they grow into adulthood. The transition of care must be seamless in medical treatment as the patients grow and in other medical aids such as subsidies for medical expenses in the health care system. Inappropriate transitional care, either medical or social, directly causes poorer prognosis for many early-onset diseases, including primary dyslipidemia caused by genetic abnormalities. Many primary dyslipidemias are designated as intractable diseases in the Japanese health care system for specific medical aids, as having no curative treatment and requiring enormous treatment costs for lipid management and prevention of complications. However, there are problems in transitional medicine for primary dyslipidemia in Japan. As for the medical treatment system, the diagnosis rate remains low due to the shortage of specialists, their insufficient link with generalists and other field specialists, and poor linkage between pediatricians and physicians for adults. In the medical care system, there is a mismatch of diagnostic criteria of primary dyslipidemias between children and adults for medical care expense subsidization, as between The Program for the Specific Pediatric Chronic Diseases and the Program for Designated Adult Intractable Diseases. This could lead some patients subsidized in their childhood to no longer be under the coverage of the aids after transition. This review intends to describe these issues in transitional medicine of primary dyslipidemia in Japan as a part of the efforts to resolve the problems by the Committee on Primary Dyslipidemia under the Research Program on Rare and Intractable Disease of the Ministry of Health, Labour and Welfare of Japan.


Asunto(s)
Dislipidemias , Humanos , Dislipidemias/terapia , Dislipidemias/epidemiología , Japón/epidemiología , Adulto , Transición a la Atención de Adultos , Niño
10.
Curr Probl Cardiol ; 49(6): 102516, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38492614

RESUMEN

The study "Inclisiran siRNA technology in the management of dyslipidemia: A narrative review of clinical trials" evaluates inclisiran's efficacy and safety in reducing LDL cholesterol levels across diverse patient populations. Twelve clinical trials were reviewed, demonstrating consistent LDL-C reduction, even in statin intolerance or resistance cases, with sustained efficacy observed over various durations, some extending up to four years. Inclisiran exhibited a favorable safety profile, suggesting its potential as a well-tolerated treatment option. Despite promising findings, the limitations include the short duration of some trials and the exclusion of non-English language studies, warranting further research. Future studies should focus on the long-term safety and efficacy in diverse patient populations and explore the broader clinical implications of inclisiran. Although inclisiran shows promise in dyslipidemia management, comprehensive research is needed to understand its full potential in cardiovascular medicine.


Asunto(s)
LDL-Colesterol , Dislipidemias , ARN Interferente Pequeño , Humanos , Dislipidemias/terapia , Dislipidemias/tratamiento farmacológico , Dislipidemias/genética , ARN Interferente Pequeño/uso terapéutico , LDL-Colesterol/sangre , Ensayos Clínicos como Asunto
12.
Indian Heart J ; 76 Suppl 1: S101-S103, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38360458

RESUMEN

Indians have early onset atherosclerotic cardiovascular disease and acquire the risk factors at a younger age, and hence we need to aggressively address the management of dyslipidemia in the young. Cholesterol levels early in life will influence the development of atherosclerosis. Young atherosclerotic cardiovascular disease (ASCVD) patients (18-40 yrs) should receive lipid-lowering drugs to reduce LDL-C<55 mg. Due to the asymptomatic nature of dyslipidemia, early screening will enable the implementation of management strategies which will decrease future cardiovascular events. In this review, we will provide insights into identifying and managing dyslipidemia in the 18-40 years age group (young adults). It is suggested that early detection and more aggressive management of dyslipidemia in young adults with or without risk factors like diabetes, hypertension, tobacco and central obesity, might reduce the risk of CV events occurring later in life. Although lifestyle modification is the mainstay of treatment (dietary recommendations, exercise, tobacco cessation, weight reduction, etc.) but in certain young adults we suggest use of statins in low dose or non-statin drugs if they have associated risk factors, LDL-C >160 mg or a high coronary calcium score. Young adults who are carriers of FH gene should receive aggressive lifestyle modification and appropriate antilipidemic therapy.


Asunto(s)
Aterosclerosis , Enfermedades Cardiovasculares , Dislipidemias , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Humanos , Adulto Joven , LDL-Colesterol , Enfermedades Cardiovasculares/prevención & control , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Dislipidemias/epidemiología , Dislipidemias/terapia , Hipolipemiantes/uso terapéutico , Aterosclerosis/diagnóstico , Factores de Riesgo
13.
Curr Opin Endocrinol Diabetes Obes ; 31(2): 70-77, 2024 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-38334488

RESUMEN

PURPOSE OF REVIEW: The aim of this review is to present the clinical indications of apolipoprotein C-III (apoC3) inhibition in the therapeutic arsenal for the treatment of lipid disorders and associated risks and to compare the most advanced modalities of apoC3 inhibition currently available or in development, specifically APOC3 antisense oligonucleotides (ASO) and small interfering RNA (siRNA). RECENT FINDINGS: ApoC3 inhibition significantly decreases triglyceride levels by mechanisms coupling both lipoprotein lipase (LPL) upregulation and LPL-independent mechanisms. The main apoC3 inhibitors in advanced clinical development are the GalNAc-ASO olezarsen and the GalNAc-siRNA plozasiran. Clinical studies conducted with volanesorsen, the olezarsen precursor, showed a favorable effect on hepatic steatosis (nonalcoholic fatty liver disease, NAFLD). Olezarsen does not appear to be associated with the main side effects attributed to volanesorsen including thrombocytopenia. Plozasiran is in advanced clinical development and requires subcutaneous injection every 3 months and present to-date an efficacy and safety profile comparable to that of the monthly ASO. SUMMARY: Inhibition of apoC3 is effective across all the spectrum of hypertriglyceridemia, might have a favorable effect on hepatic steatosis (NAFLD) and the effect of apoC3 inhibition on cardiovascular risk is not limited to its effect on plasma triglycerides. APOC3 GalNAc-conjugated ASO and siRNA are both effective in decreasing plasma apoC3 and triglyceride levels.


Asunto(s)
Dislipidemias , Enfermedad del Hígado Graso no Alcohólico , Humanos , Enfermedad del Hígado Graso no Alcohólico/tratamiento farmacológico , ARN Interferente Pequeño/genética , ARN Interferente Pequeño/uso terapéutico , Apolipoproteína C-III/genética , Oligonucleótidos Antisentido/uso terapéutico , Triglicéridos , Dislipidemias/genética , Dislipidemias/terapia
14.
Curr Probl Cardiol ; 49(4): 102419, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38246315

RESUMEN

RNA interference therapies, particularly small interfering RNAs (siRNAs) like Inclisiran, have shown great potential in managing dyslipidemia, a significant risk factor for cardiovascular disease. Inclisiran targets pro-protein convertasesubtilisin/kexin type 9 (PCSK9) mRNA to reduce low-density lipoprotein cholesterol (LDL-C) levels. This review evaluates Inclisiran's efficacy, safety, and clinical applications in managing dyslipidemia. A review of clinical trials evaluating Inclisiran's efficacy and safety in dyslipidemia management was conducted. PubMed, Embase, Google Scholar and Scopus were searched for relevant trials. Inclusion criteria covered clinical trials in English, published within the last six years, involving human subjects. 12 clinical trials were included in this review, demonstrating Inclisiran's consistent efficacy in reducing LDL-C levels across diverse patient populations, even in statin intolerance or resistance cases. The efficacy was observed over various durations, with some trials extending up to 4 years. Inclisiran demonstrated a favourable safety profile, with mild adverse events reported in most trials, suggesting its potential as a well-tolerated treatment option. Inclisiran's consistent efficacy and safety profile make it a promising option for managing dyslipidemia. Future studies should confirm its long-term effects and explore its clinical implications in diverse patient populations and high-risk scenarios.


Asunto(s)
Dislipidemias , Proproteína Convertasa 9 , Humanos , LDL-Colesterol , ARN Interferente Pequeño/uso terapéutico , Dislipidemias/genética , Dislipidemias/terapia
15.
Trials ; 25(1): 22, 2024 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-38172967

RESUMEN

BACKGROUND: The main contributors to death and disability from chronic illnesses in developing nations are elevated blood pressure (hypertension), blood sugar (diabetes mellitus), and blood cholesterol (dyslipidaemia). Even though there are affordable treatments, the treatment gap for these conditions is still significant. Few pilot studies from industrialized nations discuss the value of peer-led interventions for achieving community-level management of blood pressure and blood sugar. This study aims to evaluate the effectiveness of peer-led intervention compared to standard care in achieving control of selected non-communicable diseases (NCDs) in Indian context at 1 year of intervention among people of 30-60 years with hypertension and/or diabetes mellitus and/or dyslipidaemia. METHODS: A cluster-randomized controlled trial will be conducted in villages of two rural blocks of the Khordha district of Odisha from August 2023 to December 2024. A total of 720 eligible participants (360 in the intervention group and 360 in the control group) will be recruited and randomized into two study arms. The participants in the intervention arm will receive a peer-led intervention model for 6 months in addition to standard care. The sessions will be based on the six domains of NCDs - self-care, follow-up care, medication, physical activity, diet, limiting substance use, mental health and co-morbidities. The mean reduction in blood pressure, HbA1C, and blood cholesterol in the intervention arm compared to the standard care arm will be the main outcome. DISCUSSION: The increasing burden of NCDs demands for newer strategies for management. Peer-led interventions have proven to be useful at the international level. Incorporating it in India will have remarkable results in controlling NCDs. TRIAL REGISTRATION: Clinical Trial Registry of India (CTRI) CTRI/2023/02/050022. Registered on 23 February 2023.


Asunto(s)
Diabetes Mellitus , Dislipidemias , Hipertensión , Enfermedades no Transmisibles , Humanos , Glucemia , Colesterol , Diabetes Mellitus/terapia , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Dislipidemias/terapia , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/terapia , Enfermedades no Transmisibles/epidemiología , Enfermedades no Transmisibles/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Adulto , Persona de Mediana Edad
16.
Indian Heart J ; 76 Suppl 1: S80-S82, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37956957

RESUMEN

Diabetes mellitus is a metabolic disorder that often predisposes to cardiovascular diseases (CVD). CVD is an important cause of morbidity and mortality in diabetes. The typical diabetic dyslipidaemia is characterized by low HDL cholesterol, high triglycerides with mildly increased or even normal LDL. This attenuated rise in LDL is due to the more atherogenic small dense LDL particles. Genetic factors, obesity, lack of physical activity, alcohol abuse, poorly controlled glucose levels are some of the common risk factors for dyslipidaemia. Non-pharmacological management of dyslipidaemia is important and includes modification in the diet, increase in physical activity and efforts to reduce weight. Statins remain the mainstay of pharmacotherapy for dyslipidaemia in diabetes. Due to the small dense LDL, even patients with diabetes who have normal LDL cholesterol, achieve reduction in cardiovascular risk with statin therapy. Those patients who do not achieve acceptable LDL reductions with statin alone can be treated with combination therapy of ezetimibe with statins. Many novel therapies have also emerged such as bempedoic acid and proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors. The targets for LDL cholesterol depend upon the patients underlying cardiovascular risk category. The use of pharmacotherapy for lowering triglycerides in patients with mild to moderate hypertriglyceridemia and diabetes is still a matter of debate. Proper management of dyslipidaemia is critical component of treatment of diabetes mellitus.


Asunto(s)
Anticolesterolemiantes , Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Dislipidemias , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Proproteína Convertasa 9/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , LDL-Colesterol , Dislipidemias/complicaciones , Dislipidemias/epidemiología , Dislipidemias/terapia , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Triglicéridos , Anticolesterolemiantes/uso terapéutico
17.
Diabetes Obes Metab ; 25(12): 3700-3708, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37694759

RESUMEN

AIM: To assess the implementation of the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline recommendations for lipid-lowering therapies among more than 30 000 patients with type 1 diabetes (T1D) and type 2 diabetes (T2D) in a German and Austrian registry from 2020 to 2022. MATERIALS AND METHODS: Registry data from 2020 and 2021 of 32 170 adult patients (8314 patients with T1D and 23 856 with T2D) were stratified according to the 2019 ESC/EAS risk categories, and guideline-based low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) goal attainment was analysed. RESULTS: In patients with T1D (median age 38.35 [20.51-57.13] years), overall statin use was 19.3%, ezetimibe use was 2.2% and the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors or fibrates was less than 1%. In patients with T2D (median age 68.76 [58.86-78.39] years), 45.7% received statins, 3.4% received ezetimibe, and fibrates and PCSK9 inhibitors were used by 1% and 0.1%, respectively. Among patients with T1D, 6.16% reached their risk-based recommended LDL-C goal of less than 55 mg/dL (very high risk), 10.97% of less than 70 mg/dL (high risk), and 69.50% of less than 100 mg/dL (moderate risk), respectively. In patients with T2D, 11.81% reached their risk-based goal of LDL-C less than 55 mg/dL, 16.25% of less than 70 mg/dL, and 51.33% of less than 100 mg/dL. Non-HDL-C goals were reached more often, with 15.3%, 25.52% and 91.61% in patients with T1D and 18.56%, 17.96% and 82.30% in patients with T2D for very high, high and moderate risk, respectively. CONCLUSION: Approximately 2 years after publication of the guidelines, LDL-C and non-HDL-C goal attainment was rarely achieved in patients with T1D and T2D with a high or very high cardiovascular risk.


Asunto(s)
Anticolesterolemiantes , Aterosclerosis , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Dislipidemias , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Adulto , Humanos , Anciano , LDL-Colesterol , Proproteína Convertasa 9 , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/epidemiología , Austria/epidemiología , Objetivos , Colesterol , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Ezetimiba/uso terapéutico , Sistema de Registros , Ácidos Fíbricos , Anticolesterolemiantes/uso terapéutico , Dislipidemias/terapia
18.
Nutrients ; 15(16)2023 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-37630836

RESUMEN

Excess body weight and associated dyslipidemia in children and adolescents are the main risk factors for cardiovascular diseases in young adults. There is a reasonable need to develop an effective lifestyle modification program that includes various dietary therapies. A low-glycemic index (GI) diet may be recommended in the treatment of obesity. Its use is also recognized as reasonable in cardiovascular diseases, including dyslipidemia. The aim of the presented nutritional intervention program was to evaluate the effectiveness of an energy-balanced diet based on the principal recommendation on Cardiovascular Health Integrated Lifestyle Diet-2 (CHILD-2) and low-GI products (LGI diet) in children and adolescents with excess body weight and dyslipidemia. The study involved 64 children and adolescents (44 boys and 20 girls) aged 8-16 with overweight or obesity and dyslipidemia. For 8 weeks, the participants followed a dietary treatment using two types of diets: one based on products with a low GI, and one standard therapy diet. During this time, they participated in three visits with a dietitian, during which the assessment of their current and habitual food intake was made, and anthropometric measurements and blood pressure were taken. Patients were under the care of a pediatrician who qualified them for the study and ordered lipid profile tests. This article presents the design, protocol of the nutritional intervention program, and baseline data. The collected results will be used to develop practical nutritional recommendations for children and adolescents with excess body weight and dyslipidemia.


Asunto(s)
Enfermedades Cardiovasculares , Dislipidemias , Masculino , Femenino , Adulto Joven , Humanos , Adolescente , Peso Corporal , Aumento de Peso , Obesidad , Dislipidemias/terapia
19.
Curr Atheroscler Rep ; 25(9): 613-617, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37548846

RESUMEN

PURPOSE OF REVIEW: Dyslipidemia is a common condition characterized by abnormal lipid levels in the blood, which can increase the risk of cardiovascular disease. Physical activity and participation in sports have been shown to have a positive impact on lipid profiles and reduce the risk of dyslipidemia. Additionally, regular physical activity can lead to weight loss and improved insulin sensitivity, both of which are associated with improved lipid profiles. This review aims to provide an overview on the utility of physical activity in the management of dyslipidemia. RECENT FINDINGS: Improvements in lipid profiles were observed across both short- and long-term durations of high-intensity interval training (HIIT) and moderate intensity interval training (MIIT). However, it seems that more significant improvements in lipid profiles can be achieved with longer periods of physical activity and more intense exercise regimens. Several studies have investigated the relationship between aerobic exercise and HDL cholesterol (HDL-C), and the results suggest that HDL-C levels are more responsive to aerobic exercise compared to LDL cholesterol (LDL-C) and triglycerides (TG). Although findings on the effect of aerobic exercise on LDL-C levels have been inconsistent, there may still be beneficial changes in LDL-C subfractions that could provide cardiovascular protection. One such subfraction is plasma Lp(a), which contains Apo(a). However, unlike other LDL subfractions, Lp(a) is determined by genetics and is not influenced by physical activity. Therefore, it cannot be improved through exercise. Exercise is commonly believed to lead to a decrease in plasma TG concentrations. However, it is important to note that the baseline TG level may play a crucial role in determining the effect of exercise on the TG response. Factors such as individual variability and metabolic differences can influence the response of TG levels to exercise. Overall, exercise plays a crucial role in improving lipid profiles and promoting cardiovascular health. In conclusion, sport can be considered a form of medicine for dyslipidemia. Regular physical activity and participation in sports can improve lipid profiles, reduce the risk of cardiovascular disease, and improve overall health. It is essential to incorporate exercise and a healthy lifestyle into one's daily routine to prevent and manage dyslipidemia effectively.


Asunto(s)
Enfermedades Cardiovasculares , Dislipidemias , Humanos , LDL-Colesterol , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Triglicéridos , HDL-Colesterol , Factores de Riesgo , Dislipidemias/terapia
20.
Sci Rep ; 13(1): 11036, 2023 07 07.
Artículo en Inglés | MEDLINE | ID: mdl-37419924

RESUMEN

Dyslipidaemia is an established cardiovascular risk factor. This study aimed to determine the pooled prevalence of dyslipidaemia in Malaysian adults. A systematic review and meta-analysis of all cross-sectional, longitudinal observational studies which reported the prevalence of elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), and reduced high-density lipoprotein cholesterol (HDL-c) in adults 18 years old and older, was conducted. A comprehensive search of PubMed and Cochrane Central Register of Controlled Trials (which included Medline, EMBASE and major trial registers) from inception to October 18, 2022, was performed. Risk-of-bias was evaluated using the Johanna-Briggs Institute Prevalence Critical Appraisal Tool, while certainty of evidence was assessed using an adapted version of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Random-effects meta-analyses were performed using MetaXL. This report follows the PRISMA reporting guidelines. The protocol was registered with PROSPERO (CRD42020200281). 26 556 studies were retrieved and 7 941 were shortlisted initially. From this, 70 Malaysian studies plus two studies from citation searching were shortlisted; 46 were excluded, and 26 were included in the review (n = 50 001). The pooled prevalence of elevated TC (≥ 5.2 mmol/L), elevated LDL-c (≥ 2.6 mmol/L), elevated TG (≥ 1.7 mmol/L), and low HDL-c (< 1.0 mmol/L in men and < 1.3 mmol/L in women) were 52% (95% CI 32-71%, I2 = 100%), 73% (95% CI 50-92%, I2 = 100%), 36% (95% CI 32-40%, I2 = 96%), and 40% (95% CI 25-55%, I2 = 99%), respectively. This review found that the prevalence of all dyslipidaemia subtypes is high in Malaysian adults. Ongoing efforts to reduce cardiovascular diseases in Malaysia should integrate effective detection and treatment of dyslipidaemia.


Asunto(s)
Dislipidemias , Hipercolesterolemia , Masculino , Humanos , Adulto , Femenino , Adolescente , LDL-Colesterol , Prevalencia , Malasia/epidemiología , Estudios Transversales , Colesterol , Triglicéridos , HDL-Colesterol , Dislipidemias/epidemiología , Dislipidemias/terapia
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