Coronary Disease ; drug therapy ; Humans ; Hypolipidemic Agents ; administration & dosage ; therapeutic use

Cardiovascular Diseases ; drug therapy ; prevention & control ; Humans ; Hypolipidemic Agents ; administration & dosage ; therapeutic use ; Risk Reduction Behavior

OBJECTIVETo probe into the mechanism of electroacupuncture intervention for lipid metabolism of metabolic syndrome patients.

METHODSEighty cases of metabolic syndrome were randomly divided into an electroacupuncture combined with western medicine group (observation group) and a simple western medicine group (control group), 40 cases in each group. The observation group was treated with electroacupuncture at Back shu points, Zusanli (ST 36),Zhongwan (CV 12),Sanyinjiao (SP 6) etc. as main combined with oral administration of Simvastatin, Glipizide XL, and Felodipine sustained-release tablets for lipid-lowering, glucose-lowering and antihypertensive treatment; the control group was treated with oral administration of western medicine only (the medicine was the same with observation group). The Body Mass Index (BMI) and the blood lipid of the patients were detected respectively before and after treatment.

RESULTSThe BMI, Three Acids Glyceride (TG), Total Cholesterol(TC), Low Density Lipoprotein Cholesterol (LDL-C) and High Density Lipoprotein Cholesterol (HDL-C) were compared respectively before and after treatment, there were significant differences between them in observation group (all P < 0.01); while in control group, there were significant differences of TG,TC,LDL-C and HDL-C before and after treatment (all P < 0.01), and with no significant difference in BMI before and after treatment. There were significant differences of BMI,TG,TC,LDL-C and HDL-C between two groups after treatment (P < 0.01, P < 0.05).

CONCLUSIONThe electroacupuncture has an obvious effect to reduce body mass, and acupuncture combined with medication has a better effect of improving the lipid metabolism than simple medication.

Acupuncture Points ; Adult ; Body Mass Index ; Electroacupuncture ; Female ; Humans ; Hypolipidemic Agents ; administration & dosage ; Lipid Metabolism ; Lipids ; blood ; Male ; Metabolic Syndrome ; drug therapy ; metabolism ; therapy ; Middle Aged

OBJECTIVETo compare the physicians' lipid lowering drug prescribing behavior and knowledge on dyslipidemia before and at 8 months after new-issued blood-lipid reports in our hospital.

METHODBlood-lipid reports in our hospital is newly modified in that the classification of dyslipidemia and lipid-lowering guideline and target lipid level are listed on the back of lipid report besides the normal lipid value listed immediately after the measured lipid levels. Physicians' lipid lowering drug prescribing behavior and knowledge on dyslipidemia before and at 8 months after new-issued blood-lipid reports were examined in 143 doctors from various departments before and at 8 months after new-issued lipid reports.

RESULTSAt 8 months after the new issued lipid reports, doctors' cognition rate about the guideline was significantly increased [83.9% (120/143) vs. 67.1% (96/143), P < 0.001] and the guideline was considered more helpful on daily practice [75.3% (58/77) vs. 55.8% (43/77), P = 0.005] compared to baseline. However, the prescription rate of dyslipidemia therapy did not change significantly (69.2% vs. 63.2%, P = 0.117) at 8 months after the new issued lipid reports.

CONCLUSIONSThe modification of the blood-lipid reports improved doctors' knowledge on dyslipidemia and on the "Chinese guidelines on prevention and treatment of dyslipidemia in adults". However, the lipid lowering drug prescribing behavior remained unchanged at 8 months after the modification of the lipid reports. Further investigation is warranted to see if the lipid lowering drug prescribing behavior could be changed in the long-term.

Dyslipidemias ; blood ; drug therapy ; Guideline Adherence ; Health Knowledge, Attitudes, Practice ; Humans ; Hypolipidemic Agents ; administration & dosage ; therapeutic use ; Lipids ; blood ; Physicians ; Practice Patterns, Physicians' ; Prescriptions ; Research Report

Cardiovascular disease due to atherosclerosis is a leading cause of death around the world, including Singapore. Current treatment strategies primarily target low-density lipoprotein (LDL) cholesterol levels. Low levels of high-density lipoprotein (HDL) cholesterol and high triglyceride (TG) levels have been shown to increase the risk of coronary heart disease, but the clinical benefits of raising low HDL cholesterol have only been proven in a limited number of studies. This guide provides an approach on managing low HDL cholesterol levels in terms of lifestyle modifications and pharmacotherapy.
Coronary Disease ; prevention & control ; Drug Therapy, Combination ; Exercise ; Fenofibrate ; administration & dosage ; Humans ; Hypertriglyceridemia ; drug therapy ; therapy ; Hypoalphalipoproteinemias ; drug therapy ; therapy ; Hypolipidemic Agents ; administration & dosage ; Life Style ; Male ; Middle Aged ; Simvastatin ; administration & dosage

To investigate the practicability of establishing zebrafish lipid-lowering drug screening model and the effect of berberine (BBR) on hyperlipidemic zebrafish. Three-month-old zebrafishes were fed with 4% cholesterol for 0, 2, 4, 8, 14, 20, 25, 30 days, and the level of total cholesterol in serum was measured. Zebrafish were randomly divided into four groups: the control group, the high cholesterol diet group, the 0.01% simvastatin-treated group, the 0.1% berberine-treated group and the 0.2% berberine-treated group. The levels of total cholesterol (TC), triglyceride (TC), low density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) in serum were measured; the expression of hepatic HMGCR, LDLR and CYP7A1a mRNA expressions were detected by real time PCR. Oil red O staining was performed to observe the changes in fat content in the liver. According to the result, the level of serum TC in the 4% cholesterol diet group significantly was higher than that of the normal control group in a time-dependent manner and reached a stable level at the 20th day. The BBR group showed significant decreases in the levels of TC, TG and LDL-c, HMGCR mRNA expression and fat content and increases in LDLR and CYP7A1a mRNA. The hyperlipidemia zebrafish model was successfully established by feeding with 4% cholesterol for 20 days. The findings lay a foundation for further screenings on lipid-lowering drugs.
Animals ; Berberine ; administration & dosage ; Cholesterol ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Hyperlipidemias ; drug therapy ; metabolism ; Hypolipidemic Agents ; administration & dosage ; Liver ; drug effects ; metabolism ; Male ; Triglycerides ; metabolism ; Zebrafish ; metabolism

AIMTo study the pharmacokinetics and bioequivalence of acipimox sustained-release tablets (SRT) after a single and multiple oral dose in healthy dogs.

METHODSThe plasma concentrations of of SRT and reference capsules with a single and multiple oral doses.

RESULTSThe drug concentration-time profiles fitted to a noncompartment model. After a single dose administration of sustained-release tablets and capsules, the pharmacokinetic parameters were as follows: AUC were (158 +/- 30) and (147 +/- 37) microg x h x mL(-1); Tmax were (4.3 +/- 0.8) and (2.6 +/- 1.3) h; Cmax were (29 +/- 6) and (42 +/- 10) microg x mL(-1); T(1/2) were (2.3 +/- 0.7) and (1.60 +/- 0.10) h; MRT were (6.0 +/- 0.8) and (3.9 +/- 0.7) h, respectively. The relative bioavailability of the sustained-release tablet was (108 +/- 16) %. After a multiple oral administration of sustained-release tablets and capsules, the pharmacokinetic parameters were as follows: AUC were (209 +/- 23) and (195 +/- 26) microg x h x mL(-1); Tmax were (6.3 +/- 0.8) and (3.4 +/- 1.5) h; Cmax were (27 +/- 4) and (36 +/- 5) microg x mL(-1); Cmmin were (2.2 +/- 1.0) and (0.20 +/- 0.20) microg x mL(-1); Cav were (8.7 +/- 1.0) and (8.1 +/- 1.1) micro x mL(-1); FI were (293 +/- 73) % and (448 +/- 91) % , respectively. The relative bioavailability of the sustained-release tablet was (114 +/- 19) %.

CONCLUSIONThe results of two one-side test from single dose administration shown that two preparations were bioequivalent. The Cmax of sustained-release tablet was lower than that of capsules, while the Tmax and MRT of sustained-release tablet were higher than that of capsule, which indicating a good retarding effect. The results from multiple dose administration also shown that two preparations were bioequivalent and the DF of sustained-release tablet was significant lower than that of capsule.

Administration, Oral ; Animals ; Area Under Curve ; Biological Availability ; Capsules ; Delayed-Action Preparations ; Dogs ; Dose-Response Relationship, Drug ; Hypolipidemic Agents ; administration & dosage ; pharmacokinetics ; Pyrazines ; administration & dosage ; pharmacokinetics ; Random Allocation ; Tablets ; Therapeutic Equivalency

OBJECTIVEThe aim of this study was to evaluate the efficacy and safety of combination therapy with simvastatin and fenofibrate in patients with combined hyperlipidemia.

METHODSA total of 221 patients with combined hyperlipidemia were randomly assigned to receive 10 mg simvastatin (n = 72) or 200 mg fenofibrate (n = 68), or a combination of 10 mg simvastatin + 200 mg fenofibrate (n = 81) for 6 months. Lipid profiles, physical and laboratory investigations for adverse effects were assessed.

RESULTS(1) Combination treatment were more effective in normalizing lipid profile than any monotherapy. Serum TC, LDL-C, and TG were reduced by 30%, 37% and 56% respectively, whilst HDL-C significantly increased by 24% (all P < 0.01). The improvement in TG and HDL-C achieved by combination treatment was superior to fenofibrate or simvastatin alone. (2) The success rate of TC, LDL-C and TG control in the combination therapy group were 51%, 55% and 61% respectively, with an overall success rate (all three together) of 45%, which was superior to either drug given as monotherapy. (3) All treatments were well tolerated with no increase in adverse events for combination therapy versus monotherapy.

CONCLUSIONThe results of this study demonstrated that combination therapy with fenofibrate (200 mg/day) and low-dose simvastatin (10 mg/day) is more effective than monotherapy in patients with combined hyperlipidemia, and is generally safe and well tolerated.

Drug Therapy, Combination ; Female ; Fenofibrate ; administration & dosage ; adverse effects ; therapeutic use ; Humans ; Hyperlipoproteinemia Type V ; drug therapy ; Hypolipidemic Agents ; administration & dosage ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Simvastatin ; administration & dosage ; adverse effects ; therapeutic use

OBJECTIVETo observe the effects of compound red yeast rice extract (CRYRE) on blood lipids, hemorheology and blood coagulant system in rats with hyperlipidemia.

METHODSD rats were randomly divided into six groups: normal control group, model group, Xuezhikang group (0. 24 g x kg(-1)), CRYRE high dose group (2.4 g x kg(-1)), middle dose group (1.2 g x kg(-1)) and low dose group (0.6 g x kg(-1)). The normal control rats were given pure water, and rats of other five groups were given 10 mL kg lipid emulsion and subjected to daily intragastric administration simultaneously in two days, continuously for 3 weeks. After the last medication, all the rats were sacrificed for measurement of blood lipids, hemorheology and coagulation factors.

RESULTCRYRE 2.4 g x kg(-1) could significantly reduce the serum TG, TC levels and increase the HDL-C level (P < 0.01, P < 0.05). CRYRE 0.6-2.4 g x kg(-1) could significantly increase the ratios of HDL-C/TG,HDL-C/TC and HDL-C/LDL-C (P < 0.01). CRYRE 2.4 g x kg(-1) also reduced whole blood viscosity and plasma viscosity (P < 0.01, P < 0.05), prolonged active partial thromboplastin time, and lowered fibrinogen content (P < 0.01, P < 0.05).

CONCLUSIONCRYRE 2.4 g x kg(-1) could reduce blood lipids, blood viscosity and fibrinogen content, improve blood circulation, and depress the alteration of blood coagulant system resulted from lipid metabolic disorder in rats with hyperlipidemia.

Animals ; Biological Products ; administration & dosage ; chemistry ; Blood Circulation ; drug effects ; Disease Models, Animal ; Humans ; Hyperlipidemias ; blood ; drug therapy ; physiopathology ; Hypolipidemic Agents ; administration & dosage ; chemistry ; Lipids ; blood ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVELandmark trials have demonstrated that statins can reduce the risk of coronary events. Despite the widespread use of statins in the settings of primary and secondary prevention of CHD, withdrawal of statins is a frequent problem in clinical practice. Several recent clinical studies have suggested that withdrawal of statin therapy might be associated with an increase in thrombotic vascular events and the onset of acute coronary syndromes. However, the effects of discontinuing of statins treatment on endothelial function and underlying mechanism are unknown. Objectives We investigated the effects after withdrawal of simvastatin on brachial artery endothelial function in patients unreached cholesterol target with coronary heart disease (CHD) or CHD risk factors.

METHODSWe included 33 patients with established CHD or CHD risk factors, whose serum cholesterol did not achieve NCEP target level. They were administered simvastatin (20 mg) for 4 weeks. Endothelial dependent flow-mediated vasodilation (FMD) was assessed in the brachial artery using high-resolution ultrasound at baseline, after 4 weeks of simvastatin and after termination of therapy 1 week. We evaluated fasting serum lipid profiles and vasoactive substances simultaneously, included nitric oxide (NO), endothelin (ET), 6-keto-PGF1(alpha) and thromboxane B(2) (TXB(2)), which were measured as plasma prostacyclin and TXA(2) respectively.

RESULTSSimvastatin treatment reduced low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels and improved endothelial-dependent vasodilation in patients after 4 weeks. Withdrawal of simvastatin, however, FMD showed a significant reduction [(4.82 +/- 0.71)% vs (11.51 +/- 0.87)%, P < 0.01], that remained in low level after 1 week, and the FMD were even lower than the baseline values [(4.82 +/- 0.71)% vs (5.89 +/- 0.65)%, P < 0.01]. After terminating simvastatin treatment, serum NO and plasma 6-keto-PGF1(alpha) levels decreased, as well as plasma ET and serum LDL-C levels increased. But there was no significant difference between plasma TXB(2) levels before and after withdrawal of simvastatin (P > 0.05). Overall, there were significant positive correlations between withdrawal-induced changes in FMD and serum NO level (r = 0.674, P = 0.004), whereas no correlations were shown between the changes in FMD and serum LDL-C level (r = -0.414, P = 0.083).

CONCLUSIONSAbrupt withdrawal of simvastatin therapy resulted in the significant adverse impact on brachial artery endothelial function in patients unreached cholesterol target with CHD or CHD risk factors. Termination of therapy may suppress endothelial NO production and impair endothelial function that is independent of lipid-lowering effect.

Aged ; Brachial Artery ; drug effects ; Cholesterol, LDL ; blood ; Coronary Disease ; drug therapy ; physiopathology ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Hypolipidemic Agents ; administration & dosage ; Male ; Middle Aged ; Nitric Oxide ; blood ; Risk Factors ; Simvastatin ; administration & dosage ; Vasodilation