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Tytuł pozycji:

Atherosclerosis, cholesterol, nutrition, and statins - a critical review

Tytuł :
Atherosclerosis, cholesterol, nutrition, and statins - a critical review
Index Terms :
ATHEROSCLEROSIS/*prevention & control
ATORVASTATIN/therapeutic use
SIMVASTATIN/therapeutic use
FOLIC ACID/metabolism
FOLIC ACID/pharmacology
KORONARSKLEROSE/Verhütung & Bekämpfung
ATHEROSKLEROSE/*Verhütung & Bekämpfung
therapeutische Anwendung
SIMVASTATIN/therapeutische Anwendung
Mediterranean-style nutrition
Mediterrane Ernährung
ddc: 610
Tytuły dodatkowe :
Atherosklerose, Cholesterin, Ernährung und Statine - eine kritische Übersicht
Źródło :
GMS German Medical Science; VOL: 5; DOC04 /20070816
Wydawca :
German Medical Science GMS Publishing House; Düsseldorf 2007-08-16
Dodane szczegóły :
Gebbers, JO
Typ dokumentu :
Zasób elektroniczny
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Dostępność :
Open access content. Open access content
Pozostałe numery :
Źródło wspomagające :
From OAIster®, provided by the OCLC Cooperative.
Numer akcesji :
Zasób elektroniczny
Atherosclerosis, which causes approximately half of all deaths of adults over age 60 in industrialized nations, is a pandemic among inappropriately nourished and/or physically hypoactive children, adolescents, and adults world wide. Although nowadays statins are widely prescribed to middle age and elderly adults with high blood lipid levels as pharmacological prevention for the late complications of atherosclerosis, from a critical point of view statins seem not to solve the problem, especially when compared with certain natural ingredients of our nutrition like micronutrients as alternative strategy. Statin ingestion is associated with lowering of serum cholesterol and low-density lipoprotein concentrations; some prospective studies have shown statistical associations with subsequent modest reduction of mortality from cardiovascular disease. However, specific biochemical pathways and pharmacological roles of statins in prevention of atherosclerosis, if any, are unknown. Moreover, there have been no systematic cost-benefit analyses of life-style prophylaxis versus statin prophylaxis versus combined life-style plus statin prophylaxis versus neither life-style nor statin prophylaxis for clinically significant complications of cardiovascular diseases in the elderly. Further, in the trials of effectiveness statins were not compared with management of nutrition, which is the most appropriate alternative intervention. Such studies seem to be important, as the ever increasing world population, especially in developing countries, now demand expensive statins, which may be unaffordable for mitigating the pandemic. Studies of this kind are necessary to identify more precisely those patients for whom cardiovascular benefits will outweigh the risks and costs of the statin treatment in comparison with nutritional interventions. Against the background of the current pathogenetic concept of atherogenesis some of its possible risk factors, particularly the roles of cholesterol and
Die Atherosklerose, etwa für die Hälfte aller Todesursachen der über 60jährigen in den Industrienationen verantwortlich, ist eine Pandemie unter fehlernährten und/oder körperlich hypoaktiven Kindern, Jugendlichen und Erwachsenen. Obwohl heutzutage Statine großzügig für Erwachsene im mittleren und hohen Alter mit hohen Blutfettspiegeln als pharmakologische Prävention der atherosklerotischen Spätfolgen verschrieben werden, erscheinen, kritisch betrachtet, Statine nicht die Lösung des Problems zu sein, speziell wenn ihre Wirkungen mit denen natürlicher Nahrungskomponenten, wie Mikro-Nahrungsbestandteile, als alternative Strategie verglichen werden. Die Einnahme von Statinen geht mit einer Senkung des Serumspiegels des Cholesterins und der Low-density-Lipoproteine (LDL) einher. Hierbei haben einige prospektive Studien statistische Zusammenhänge mit einer nachfolgenden bescheidenen Reduktion der Mortalität kardiovaskulärer Krankheiten gezeigt. Jedoch sind die spezifischen biochemischen Einflüsse und die pharmakologische Rolle der Statine für die Prävention der Atherosklerose unbekannt. Im weiteren sind bislang keine systematischen Kosten-Nutzen-Analysen der Lifestyle-Prophylaxe versus Statin-Prophylaxe versus kombinierter Lifestyle- und Statin-Prophylaxe versus weder Lifestyle- noch Statin-Prophylaxe für klinisch bedeutende Komplikationen kardiovaskulärer Krankheiten bei Älteren durchgeführt worden. Zudem wurden die klinischen Studien zur Statinwirkung nicht mit entsprechenden Ernährungsmaßnahmen als angemessenster Alternativintervention verglichen. Derlei Studien erscheinen deshalb wichtig zu sein, da die wachsende Weltbevölkerung, gerade auch in den wirtschaftlichen Entwicklungsländern, jetzt die teuren Statine verlangt, welche aber zur Eindämmung der Pandemie unerschwinglich sein können. Studien dieser Art sind für die genauere Definition derjenigen Personen notwendig, für die der kardiovaskuläre Nutzen die Risiken und Kosten der Statin-Therapie vergleichsweise zu Ern

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