Decrease In Low-density Lipoprotein Cholesterol Research Articles

Are (poly)phenols contained in 100% fruit juices mediating their effects on cardiometabolic risk factors? A meta-regression analysis.

The consumption of 100% fruit juices has not been associated with substantial detrimental outcomes in population studies and may even contribute to improving the cardiometabolic profile if included in a healthy balanced diet. The main contributors to such potential beneficial effects include vitamins, minerals, and likely the (poly)phenol content. This study aimed to investigate whether the (poly)phenols contained in 100% fruit juices may mediate their effects on cardiometabolic risk factors based on published randomized controlled trials (RCT). A systematic search in PubMed/MEDLINE and Embase, updated till the end of October 2022, was carried out to identify RCT providing quantitative data on (poly)phenol content in 100% fruit juices and used as an intervention to improve cardiometabolic parameters such as blood lipids, glucose, and blood pressure. Meta-regression analysis was performed to calculate the effect of the intervention [expressed as standardized mean difference and 95% confidence intervals (CI)] using the (poly)phenol content as moderator. A total of 39 articles on RCT investigating the effects of 100% fruit juices on cardiometabolic risk factors reporting data on total (poly)phenol and anthocyanin content were included in the analysis. Total (poly)phenol content was substantially unrelated to any outcome investigated. In contrast, each 100 mg per day increase in anthocyanins was related to 1.53 mg/dL decrease in total cholesterol (95% CI, -2.83, -0.22, p = 0.022) and 1.94 mg/dL decrease in LDL cholesterol (95% CI, -3.46, -0.42, p = 0.012). No other potential mediating effects of anthocyanins on blood triglycerides, glucose, systolic and diastolic pressure were found, while a lowering effect on HDL cholesterol after excluding one outlier study was observed. In conclusion, the present study showed that anthocyanins may mediate the potential beneficial effects of some 100% fruit juices on some blood lipids. Increasing the content of anthocyanins through specific fruit varieties or plant breeding could enhance the health benefits of 100% fruit juices.

#2768 DIFFERENT EFFECTS OF HYPOXIA-INDUCIBLE FACTOR PROLYL HYDROXYLASE INHIBITORS ON SERUM LIPIDS LEVELS IN HEMODIALYSIS PATIENTS

Abstract Background The activity of hypoxia-inducible factor (HIF), an oxygen-sensitive transcription factor involved in erythropoiesis, is regulated by HIF-prolyl hydroxylases. With reduced oxygen tension, the activity of these enzymes is suppressed, resulting in increased erythropoiesis. Chen et al. reported that the decrease in that total cholesterol (TC) was greater with roxadustat than with epoetin alfa, as was the decrease in low density lipoprotein-cholesterol (LDL-C) in patients undergoing dialysis [1]. Csiky et al. reported roxadustat was superior to erythropoiesis-stimulating agent (ESA) in decreasing LDL-C levels from baseline in patients on dialysis [2]. Roxadustat is an oral HIF-prolyl hydroxylase inhibitor (HIF-PHI) developed for dialysis-dependent chronic kidney disease (CKD) anemia. While the impact of HIF-PHI on mean hemoglobin (Hb) change in patients on hemodialysis (HD) has been investigated [1], its effects on serum lipid levels have yet to be explored. Clarifying such effects is particularly important because HD patients usually have lower plasma high-density lipoprotein-cholesterol (HDL-C) levels than healthy individuals. Low HDL-C levels are associated with an increased risk of death in HD patients. The effects of HIF-PHIs on dyslipidemia in patients on HD are unclear. This study aimed to investigate the effects of HIF-PHIs on serum lipid levels in HD patients. Methods We investigated the effect of HIF-PHIs in three groups by measuring the levels Hb, serum TC, LDL-C, HDL-C, triglycerides (TG), iron, total iron-binding capacity (TIBC), transferrin saturation (TSAT), ferritin. Study 1: We evaluated the efficacy of roxadustat in 13 patients (1 female and 12 males) with HD-dependent CKD anemia and dyslipidemia over 24 weeks. Study 2: We evaluated the efficacy of daprodustat in 9 patients (2 females and 7 males) with HD-dependent CKD anemia and dyslipidemia over 24 weeks. Study 3: We evaluated the efficacy of enarodustat in 15 patients (3 females and 12 males) with HD-dependent CKD anemia and dyslipidemia over 12 weeks. Results Study 1: The mean age and mean HD vintage were 77.7 and 6.6 years, respectively. After roxadustat treatment, the mean Hb values (from 10.4 to 10.7 g/dL) did not significantly change. There were no significant changes in mean serum iron, TG, ferritin. However, the following parameters showed a significant decrease: mean TC (from 138.4 to 106.6 mg/dL, p = 0.0002), LDL-C (77.7 to 53.8 mg/dL, p = 0.0002), HDL-C (from 43.3 to 35.9 mg/dL, p = 0.0005), and TSAT (from 32.6 to 31.2%, p = 0.0479). There was a significant increases in the mean TIBC (from 220.5 to 265.1 μg/dL, p = 0.0002). Study 2: The mean age and mean HD vintage were 74.6 and 3.2 years, respectively. After daprodustat treatment, the mean Hb values did not significantly change. There were no significant changes in the mean TC, LDL-C, TG, TSAT, ferritin. However, the mean HDL-C levels showed a statistically significant decrease (from 50.4 to 45.3 mg/dL, p = 0.0117). Furthermore, there were significant increases in the serum iron level (from 72.5 to 89.1 μg/dL, p = 0.0078) and the mean TIBC level (from 229.7 to 272.8 μg/dL, p = 0.0039). Study 3: The mean age and mean HD vintage were 69.3 and 8.9 years, respectively. After enarodustat treatment, the mean Hb values did not significantly change. There were no significant changes in the mean TC, LDL-C, HDL-C, TG, TSAT, ferritin, iron. There was a significant increase in the mean TIBC (from 230.0 to 259.4 μg/dL, p = 0.0151). Conclusions We found that HIF-PHIs had different effects on serum lipids levels in HD patients. Roxadustat treatment improved iron metabolism stabilized Hb levels, and significantly decreased LDL-C levels. Daprodustat and enarodustat treatment improved iron metabolism, maintained stable Hb levels.

Vascular Function and Intima-Media Thickness in Children and Adolescents with Growth Hormone Deficiency: Results from a Prospective Case-Control Study

Introduction: Growth hormone deficiency (GHD) may be associated with subtle cardiovascular abnormalities, reversible upon starting GH treatment. Data on vascular morphology and function in GHD children are scanty and inconclusive. The aim of our study was to evaluate the effects of GHD and GH treatment on endothelial function and intima-media thickness (IMT) in children and adolescents. Methods: We enrolled 24 children with GHD (10.85 ± 2.71 years) and 24 age-, sex-, and BMI-matched controls. We evaluated anthropometry, lipid profile, asymmetric dimethylarginine (ADMA), brachial flow-mediated dilatation (FMD), and IMT of common (cIMT) and internal (iIMT) carotid artery at study entry in all subjects and after 12 months of treatment in GHD children. Results: At baseline GHD, children had higher total cholesterol (163.17 ± 18.66 vs. 149.83 ± 20.68 mg/dL, p = 0.03), LDL cholesterol (91.18 ± 20.41 vs. 77.08 ± 19.73 mg/dL, p = 0.019), atherogenic index (AI) (2.94 ± 0.71 vs. 2.56 ± 0.4, p = 0.028), and ADMA (215.87 ± 109.15 vs. 164.10 ± 49.15 ng/mL, p < 0.001), compared to controls. GHD patients also exhibited increased higher waist-to-height ratio (WHtR) compared to controls (0.48 ± 0.05 vs. 0.45 ± 0.02 cm, p = 0.03). GH therapy resulted in a decrease in WHtR (0.44 ± 0.03 cm, p = 0.001), total (151.60 ± 15.23 mg/dL, p = 0.001) and LDL cholesterol (69.94 ± 14.40 mg/dL, p < 0.0001), AI (2.28 ± 0.35, p = 0.001), and ADMA (148.47 ± 102.43 ng/mL, p < 0.0001). GHD showed lower baseline FMD than controls (8.75 ± 2.44 vs. 11.85 ± 5.98%, p = 0.001), which improved after 1-year GH treatment (10.60 ± 1.69%, p = 0.001). Baseline cIMT and iIMT were comparable between the two groups, but slightly reduced in GHD patients after treatment. Conclusion: GHD children may exhibit endothelial dysfunction in addition to other early atherosclerotic markers like visceral adiposity, and altered lipids, which can be restored by GH treatment.

Lipids, lipid-lowering agents, and inflammatory bowel disease: a Mendelian randomization study.

To assess the causal role of lipid traits and lipid-lowering agents in inflammatory bowel disease (IBD). Univariable mendelian randomization (MR) and multivariable MR (MVMR) analyses were conducted to evaluate the causal association between low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and IBD. Drug-targeted MR analyzed the effects of lipid-lowering drugs on IBD, and network MR was used to analyze potential mediation effects. The levels of HDL-C had an inverse relationship with the risk of Crohn's disease (CD, OR: 0.85, 95% CI: 0.73-0.98, P = 0.024). In MVMR, the inverse relationships were found in all three outcomes. Drug-targeted MR analyses showed that with one-SD LDL-C decrease predicted by variants at or near proprotein convertase subtilisin/kexin type 9 (PCSK9), the OR values of people diagnosed with IBD, ulcerative colitis (UC) and CD were 1.75 (95%CI: 1.13-2.69, P = 0.011), 2.1 (95%CI: 1.28-3.42, P = 0.003) and 2.24 (95%CI: 1.11-4.5, P = 0.024), respectively. With one-SD LDL-C decrease predicted by variants at or near cholesteryl ester transfer protein (CETP), the OR value of people diagnosed with CD was 0.12 (95%CI: 0.03-0.51, P = 0.004). Network-MR showed that HDL-C mediated the causal pathway from variants at or near CETP to CD. Our study suggested a causal association between HDL-C and IBD, UC and CD. Genetically proxied inhibition of PCSK9 increased the risk of IBD, UC and CD, while inhibition of CETP decreased the risk of CD. Further studies are needed to clarify the long-term effect of lipid-lowering drugs on the gastrointestinal disorders.

WHO BENEFITS MORE, IN TERMS OF LIPID PROFILE?

Objective: As important as finding and treating the specific cause of a cerebral vascular event is gauging, monitoring and treating the cerebrovascular risk factors that may contribute to and/or aggravate it, with the lipid profile having particular prominence. To comparatively analyse the control of the lipid profile, between gender, throughout the Hypertension Consultation Design and method: We conducted a retrospective study including patients who attended the Hypertension Consultation from 1 January to 31 May 2022. This group was divided into two subgroups (female or male) and subsequently compared regarding the evolution of the mean values of LDL-cholesterol, -HDL, and triglycerides from the first to the last appointment they attended. Results: Overall, a decrease in LDL-cholesterol and triglycerides was obtained in both subgroups. The reduction of these two parameters was greater in the female group. The values of LDL-cholesterol did not change substantially. Conclusions: Pharmacological and non-pharmacological therapy of dyslipidaemia proved to be effective, safe and well tolerated in the group of patients with cerebrovascular disease, regardless of gender. The female gender was the one that benefited most from these measures throughout the follow-up in hypertension consultation. The widely recognised difficulty in modifying HDL in these patients was also evident.

GLUCOMANNAN AND RED RICE EXTRACT REDUCE BLOOD LIPID LEVELS IN OVERWEIGHT PATIENTS

Objective: This study aims to explore the changes in blood lipid levels, body composition, and blood pressure in healthy middle-aged overweight people with mild hypercholesterolemia following the 45-day intake of a dietary supplement containing both glucomannan and red rice extract. Design and method: The survey was designed as a single-arm non-randomized, non-blind intervention study. 31 study participants consumed a dietary supplement containing dietary fibers (Konjak glucomannan, E425ii) and red rice extract (Monascus purpureus) for 45 days. Participants were asked not to change their current diet. Their body weight, body composition, and blood pressure were measured every two weeks. Blood lipids were tested at the beginning and at the end of the intervention. Results: After 45 days, there was a significant decrease in total cholesterol (by 16-18%), LDL cholesterol (by 20-24%), and triglyceride levels (by 11-23%) in both genders. In addition, women lost on average about 1 kilogram of body weight, 1.5 kilograms in body fat, and decreased their body mass index by 0.5 kg/m2. No changes in body composition were observed among men, but their systolic pressure decreased by six mmHg on average. Conclusions: Concurrent use of glucomannan and red yeast rice extract resulted in a significant reduction in blood lipid levels in both genders. It could be a safe and effective treatment option for the population of healthy middle-aged overweight people with mild hypercholesterolemia.

Association of Multitrajectories of Lipid Indices With Premature Cardiovascular Disease: A Cohort Study.

Background The multitrajectory model can identify joint longitudinal patterns of different lipids simultaneously, which might help better understand the heterogeneous risk of premature cardiovascular disease (CVD) and facilitate targeted prevention programs. This study aimed to investigate the associations between multitrajectories of lipids with premature CVD. Methods and Results The study enrolled 78 526 participants from the Kailuan study, a prospective cohort study in Tangshan, China. Five distinct multitrajectories of triglyceride, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol over 6-year exposure were identified on the basis of Nagin's criteria, using group-based multitrajectory modeling. During a median follow-up of 6.75 years (507 645.94 person-years), 665 (0.85%) premature CVDs occurred. After adjustment for confounders, the highest risk of premature CVD was observed in group 4 (the highest and increasing triglyceride, optimal and decreasing LDL-C, low and decreasing high-density lipoprotein cholesterol) (hazard ratio [HR], 2.13 [95% CI, 1.36-3.32]), followed by group 5 (high and decreasing triglyceride, optimal and increasing LDL-C, low and decreasing high-density lipoprotein cholesterol) (HR, 2.07 [95% CI, 1.45-2.98]), and group 3 (optimal and increasing triglyceride, borderline high and increasing LDL-C, optimal and decreasing high-density lipoprotein cholesterol) (HR, 1.90 [95% CI, 1.32-2.73]). Conclusions Our results showed that the residual risk of premature CVD caused by increasing triglyceride levels remained high despite the fact that LDL-C levels were optimal or declining over time. These findings emphasized the importance of assessing the joint longitudinal patterns of lipids and undertaking potential interventions on triglyceride lowering to reduce the residual risk of premature CVD, even among individuals with optimal LDL-C levels.

The clinical effects of inclisiran, a first-in-class LDL-C lowering siRNA therapy, on the LDL-C levels in Chinese patients with hypercholesterolemia

Inclisiran is a novel siRNA therapy that inhibits the synthesis of proprotein convertase subtilisin-kexin type 9 (PCSK9) by targeting the PCSK9 mRNA, consequently, decreases low-density lipoprotein cholesterol (LDL-C). To assess the safety, PK and LDL-C lowering effects of inclisiran in the Chinese patients with elevated LDL-C despite treatment with maximally tolerated LDL-C lowering therapies. Forty Chinese patients with hypercholesterolemia (LDL-C ≥100 mg/dL) who were on maximally tolerated statin were randomized to receive a single dose of either inclisiran sodium 100 or 300mg s.c. injection (each for 15 patients) or placebo (10 patients). Safety, pharmacokinetics and pharmacodynamics (i.e., PCSK9 and LDL-C levels) were evaluated for up to 90 days after the s.c. injection of study drug. Following single subcutaneous injections inclisiran sodium at 100 mg or 300 mg, inclisiran has a relative short elimination half-life (T1/2, 6.5 hours). Both plasma PCSK9 and serum LDL-C decreased rapidly and consistently, with the maximal reduction between Day 30 and Day 60; then the decreases of PCSK9 and LDL-C were generally maintained up to 56.4% and 49.6% of 100 mg, 74.9% and 58.3% of 300 mg, respectively, at day 90. All adverse events were mild or moderate in severity, and no discontinuations due to adverse events. There were no serious adverse events being reported. Inclisiran was generally safe and well tolerated. Single dose of both Inclisiran 100 and 300 mg significantly reduced PCSK9 and LDL-C levels in Chinese patients up to Day 90. The greatest reductions were observed with the 300 mg regimen of Inclisiran. ClinicalTrials.gov: NCT04774003.

Lipid lowering effects and safety of evolocumab in Chinese patients at very high cardiovascular risk: a single-center study.

Lipid lowering effects and safety of evolocumab in Chinese patients at very high cardiovascular risk: a single-center study.

Review and assessment of the donor safety among plasma donors.

Review and assessment of the donor safety among plasma donors.

Hypoglycaemic activity of biosynthesized copper oxide nanoparticles in alloxan‐induced diabetic Wister rats

Diabetes mellitus (DM) is a metabolic disorder that affects the body's ability to produce or use insulin. This study evaluated the hypoglycaemic activity of biosynthesized copper oxide nanoparticles (CuO-NPs) in alloxan-induced diabetic Wister rats. CuO-NPs were synthesized via the green route and characterized using different analytical tools. Diabetes was induced intraperitoneally using 90 mg/kg body weight of alloxan monohydrate in albino rats. Thirty (30) rats were randomly divided into 5 groups of 6 rats each and orally treated for 21 days. Groups I and II were treated with 300 mg/kg bwt Cereus hildmannianus extract and CuO-NPs, respectively. Groups III and IV received 5 mg/kg bwt of Glibenclamide and 2 mL of normal saline, respectively, while Group V was left untreated as the diabetic control. Blood glucose (BG) levels and body weight changes were monitored at 3- and 7-day intervals, respectively, throughout 21-day treatment period. Lipid profiles, enzyme assays and histopathological studies of the liver were also carried out. Spheroidal tenorite phase of CuO-NPs with a crystallite size of 62.57 nm, surface area (20.64 m2 /g) and a UV-maximum absorption at 214.27 nm was formed. The diabetic rats treated with 300 mg/kg bwt CuO-NPs had the highest BG lowering ability (from 482.75 ± 27.70 to 124.50 ± 2.50 mg/dL). A significant difference (p < 0.05) in weight gain and serum enzymes was also observed in the CuO-NPs treated group compared with other groups. The CuO-NPs-treated group had a significant increase (p < 0.05) in HDL-cholesterol and a decrease in total cholesterol, triglycerides, LDL-cholesterol and VLDL-cholesterol compared with other groups. The green synthesized CuO-NPs nanoparticles significantly reduced (p < 0.05) blood glucose levels in rats and other associated indices and could serve as drug lead in the treatment of diabetes.

French expert group proposal for lipid-lowering therapy in the first 3 months after acute myocardial infarction.

In patients admitted for acute myocardial infarction (MI), it has been demonstrated that reducing LDL cholesterol (LDL-c) is associated with a reduction in major adverse cardiovascular events. We describe a consensual proposal made by a French group of experts for lipid-lowering therapy at the acute phase of acute myocardial infarction. A group of French experts comprising cardiologists, lipidologists and general practitioners prepared a proposal for a lipid-lowering strategy with a view to optimizing LDL-c levels in patients hospitalized for myocardial infarction. We describe a strategy for the use of statins, ezetimibe and and/or proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, with a view to reaching target LDL-c levels as early as possible. This approach, which is currently feasible in France, could considerably improve lipid management in patients after ACS, thanks to its simplicity, rapidity and the magnitude of the decrease in LDL-c that it achieves.

MiR-33a and Its Association with Lipid Profile in Patients with Carotid Atherosclerosis.

Atherosclerosis is a chronic inflammatory disease with a complex, multifactorial pathogenesis, which includes lipid metabolism alterations. miR-33a is a microRNA that plays a key role in cholesterol efflux and promotes atherosclerosis, yet its relationship with lipid markers in carotid atherosclerosis (CA) remains unclear. The objective is to evaluate possible associations between miR-33a expression and lipid biomarkers in patients with CA. This was a prospective study that included 61 patients (median age 66.0 years, 55.7% male) with evidence of CA. Lipid profile (total cholesterol, triglycerides [TG], high-density lipoprotein [HDL] and low-density lipoprotein [LDL] cholesterol) was analyzed. Extraction and quantification of miR-33a-5p/3p was performed according to protocol. Patients were further divided depending on the target LDL level (<1.8 mmol/L). Patients with CA had relatively favorable LDL levels with a median of 2.0 mmol/L. Both miR-33a-5p and miR-33a-3p levels were lower in patients with less than targeted LDL levels (37.4 and 38.3 vs. 41.8 and 42.5 respectively, p < 0.05). A significant positive correlation between expression levels of miR-33a-5p/3p and degree of carotid stenosis was found (r = 0.44 and r = 0.38 respectively, p < 0.05). In a univariate linear regression model miR-33a-3p/5p was positively associated with LDL cholesterol (p = 0.02). miR-33a up-regulation is associated with CA and may, in fact, be a key player by targeting cholesterol metabolism. A decrease in LDL cholesterol (<1.8 mmol/L) corresponded to lower levels of miR-33a, yet the direction and causality of this association remains unclear.

Protective Effect of Lycopene Rich Tomato Puree on the Development of Atherosclerosis/Heart Diseases in Animal Models

Background: Lycopene as an aliphatic carotenoid promulgated from tomato has gained the attention of new generation food and pharma scientists on the ground of its nutraceutical efficacy. It is a preeminent antioxidant known for its singlet oxygen quenching ability that reduces oxidative stress responsible for non-communicable diseases. In present investigation the health claim exploration ability of lycopene rich tomato puree as a dietary supplement was assessed by animal studies to project its hypolipidemic efficacy effective in reducing risk of heart diseases.&#x0D; Aim: The present investigation aims to determine efficacy of tomato puree lycopene in monitoring atherogenesis mechanism through synergic mode of action of notified specialty features (total cholesterol, serum triglycerides, LDL cholesterol and HDL cholesterol) in Wistar rats.&#x0D; Study Design: Wistar rats (Positive control, high fat diet fed, HFD-Stain fed and HFD-tomato puree fed) were examined for general examinations (behavioural changes and body weight), Lipid profile (total cholesterol, triglyceride, LDL and HDL cholesterol) on 0, 14 and 28th day of experiment to assess effect of tomato puree administration on wellbeing of rats against healthy, hyperlipidemic and standard drug status.&#x0D; Place and Duration of Study: MIT School of Food Technology in collaboration with Department of Pharmacology and Toxicology, College of Veterinary and Animal Sciences, Parbhani (MAFSU, Nagpur), Maharashtra. The overall study duration was for 3 months.&#x0D; Methodology: The experimental rats (Wistar) employed in present study were acquired from authorized breeder after the approval of the experimental protocol by Institutional Animal Ethical Committee (IAEC approval resolution no.: IAEC 58/19, Date 20/08/2019). Acclimatization of the animals was undertaken for 20 days during which they were provided with natural diet, pure and safe drinking water. CPCSEA (Committee for the purpose of control and supervision of experiments on animals) guidelines were followed while handling the experimental animals throughout the complete study duration. The experimental animals (32 Wistar rats) were segregated into four different groups (Positive control, high fat diet fed, HFD-Stain fed and HFD-tomato puree fed), containing 8 rats (4 male and 4 female). Animals from four distinguished groups were monitored regularly for general observations (body weights, behavioural changes and mortality changes) throughout the experimental period. The lipid profile (total cholesterol, triglyceride, HDL, LDL) of blood serum samples was recorded using auto analyser on 0, 14th and 28th day of experiment.&#x0D; Results: The data analysis, interpretation and reviewed literature infusion collectively underlined the efficacy of lycopene (tomato puree) in monitoring atherogenesis mechanism through synergic mode of action of notified specialty features (total cholesterol, serum triglycerides, LDL cholesterol and HDL cholesterol) and projected an effective gateway to support disease infused health claim. The cumulative decrease in total cholesterol (159.99 to 126.40mg/dl), serum triglycerides (114.81 to 107.34mg/dl), LDL cholesterol (40.19 to 32.90mg/dl) and increase in HDL cholesterol (19.99 to 23.87mg/dl) of treated rats represents hypolipidemic efficacy of tomato puree lycopene.&#x0D; Conclusion: The tomato puree mass being a viable lycopene source with innate antiatherogenic efficacy has rationally updated the review base critical appraisal leading to development of prototype of CVD to launch health claim. The human clinical study as a confirmation tool, may be the best option for next generation research.

Integrated solution for patients of a very high cardiovascular risk. Final results

Secondary prevention should be actively implemented at all stages of treatment and rehabilitation of patients after acute coronary syndrome (ACS). The integration of remote monitoring of patients with the transfer of vital and laboratory data into clinical practice seems promising.Aim. To evaluate the clinical and patient-centered effectiveness of the original 12-month combined face-to-face and telecare program in patients with recent ACS.Material and methods. For the present analysis the data from 84 (out of 100) patients (median age, 56 (50;61) years, 70 males) was used. These patients had to have hypertension and/or type 2 diabetes and an ACS with percutaneous revascularization within 12 months. Their low-density lipoprotein cholesterol (LDL-C) had to be above 2,4 mmol/L. Telehealth program supplemented routine care. A program contained electronic self-control diaries for blood pressure (BP) and lipid profile, and teleconsulting service (text chat). Mandatory face-to-face visits were carried out at 3 and 12 months after the enrollment. The primary end point was ∆LDL-C. Additional clinical and patient-specific endpoints were evaluated.Results. At the 12-month visit, there was a significant decrease in LDL-C by 1,6 (-2,3;-0,9) mmol/L. Besides the initial LDL-C value, the decrease in LDL-C was associated with the proper adherence to keeping diaries of BP and lipid profile (β=0,7), and the number of text messages sent by the doctor in the 1st month after the enrollment (β=0,04). In more adherent patients, the ∆LDL-C was greater by 0,49 mmol/L (95% CI (-1,2; -0,1)) after adjustment for abovementioned covariates. In 35 patients (42%), target LDL-C was achieved, in 60 patients (71%) — a decrease ≥1 mmol/l. Other lipids also have changed for the better. Moreover, adherent patients were twice as likely to achieve the target LDL-C (OR 2,2; 95% CI (0,6; 3,8)) than non-adherent ones. A decrease in office systolic BP by 5,8 mm Hg was shown (p=0,03). The number of physician-to-patient messages exceeded those from patients to physician (median 143 and 111 per patient for 12 months, respectively). The quality of life has improved, but only in terms of emotions. Satisfaction with the program remained high at all timepoints of the study.Conclusion. Our study showed the effectiveness of the integrated care in ACS patients with the telehealth tool included. Commitment to BP self-monitoring, as well as active consultative support at the first stages of rehabilitation, contributes to additional dynamic control of lipid profile, timely correction of lipid-lowering therapy with the achievement of the target LDL-C level. Most of the patients did not experience any difficulties in using the program and are ready to recommend integrated approach to other peers.

Lipid-lowering Eeficacy and Safety of High Doses of Atorvastatin and Rosuvastatin

Administration of high doses of atorvastatin 80 mg/day and rosuvastatin 40 mg/day is a part of a standard algorithm for the treatment of patients at high and very high cardiovascular risk. This treatment allows reducing atherogenic low-density lipoprotein cholesterol (LDL-C) by approximately 50 % and decreasing the risk of cardiovascular diseases. Results of prospective studies with atorvastatin and rosuvastatin demonstrated a significant (45-55 %) decrease in LDL-C and triglycerides (11-50 %). This article focuses on analysis of evidence-based retrospective database for atorvastatin and rosuvastatin in prospective studies; reviewing a retrospective database of the VOYAGER study, including subgroups of patents with type 2 diabetes mellitus or hypertriglyceridemia; evaluation of the variability of the hypolipidemic response; and analysis of the risk for development of cardiovascular diseases and their complications with the statin treatment. Rosuvastatin at the highest daily dose of 40 mg/day was superior to atorvastatin 80 mg/day by the capability for decreasing LDL-C. Both statins showed a great variability in the degree of reducing triglycerides and exerted a minimal effect on high-density lipoprotein cholesterol. According to results of completed studies, rosuvastatin 40 mg/day also was superior to high doses of atorvastatin by tolerability and safety.

The Impact of Aerobic Exercise on HDL Quantity and Quality: A Narrative Review

High-density lipoproteins comprise roughly 25-30% of the circulating proteins involved in the transport of lipids in circulation. These particles differ in size and lipid composition. Recent evidence suggests that the quality of HDL particles (which depends on shape, size and the composition of proteins and lipids determining HDL functionality) may be more important than their quantity. The functionality of HDL is mirrored by its cholesterol efflux activity, as well as its antioxidant (including the protection of LDL against oxidation), anti-inflammatory and antithrombotic properties. The results of many studies and meta-analyses imply the beneficial impact of aerobic exercise on HDL-C levels. Physical activity was found to be usually associated with an increase in HDL cholesterol and a decrease in LDL cholesterol and triglycerides. Exercise, apart from inducing quantitative alterations in serum lipids, exerts a beneficial impact on HDL particle maturation, composition and functionality. The Physical Activity Guidelines Advisory Committee Report underlined the importance of establishing a program recommending exercises that enable attainment of maximal advantage at the lowest level of risk. The aim of this manuscript is to review the impact of different types of aerobic exercise (various intensities and durations) on the level and quality of HDL.

Effect of avocado seed extract on lipid profile and atherogenic index in cyclosporine-treated rats

Hypertension is a global health issue because of its high prevalence and its association with increased risk of cardiovascular disease. This work evaluated the anti-dyslipidemic potential of aqueous extract of avocado seed (APE) (50 – 100 mg/kg) in adult male wistar rats. Twenty-five rats were used for this work and divided into five groups of 5 rats each (n= 5). Group 1 (normal control), group 2 (cyclosporine alone), group 3 (cyclosporine + 5 mg of lisinopril), group 4 and 5 (cyclosporine + 50 mg/kg and 100 mg/kg b.wt of extract respectively). Treatments lasted for 7 days and the rats were sacrificed by cervical dislocation. Plasma samples from the rats were used for lipid profile analysis such as; total cholesterol, triglyceride, and high density lipoprotein. The results showed significant (p &lt; 0.05) increase in triglyceride (TG), low density lipoprotein (LDL), and total cholesterol (TCH), as well as significant (p &lt; 0.05) decrease in HDL and atherogenic index in cyclosporine only treated rats compared with the normal control group. However, treatment with aqueous extract of avocado seed (APE) caused a significant decrease in TG, LDL, and total cholesterol, with concomitant increase in HDL concentration and atherogenic index in a dose-dependent manner. The findings of this study suggest that avocado seed extract has anti-dyslipidemic potential which could be useful in the management of hypertension and other diseases arising from dyslipidemia.

LDL lowering effect of PCSK9 inhibition is reduced in women.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of plasma low-density lipoprotein cholesterol (LDL-C) concentration, and its inhibition reduces the risk of atherosclerotic cardiovascular disease (ASCVD). We aimed to assess the sex-differential effect of either pharmacological or genetic inhibition of PCSK9 on LDL-C levels. We meta-analyzed six real-life studies (1216 men and 641 women) that investigated the effects of PCSK9 monoclonal antibodies (mAbs) on LDL-C reduction in men and women. Despite higher LDL-C levels in women at baseline [mean difference (MD)=17.4mg/dL, P<0.0001, women = 175mg/dL vs. men = 152mg/dL], the LDL-C reduction under PCSK9 mAb treatment was significantly greater in men (MD=7.6mg/dL, 95% confidence interval: 2.7-12.4, P=0.002) than in women.We tested the sex-related association of the loss-of-function variant PCSK9-R46L with LDL-C plasma levels in 382 813 individuals (219 301 women and 163 512 men) free of lipid-lowering drugs from the UK Biobank general population cohort. The magnitude of LDL-C reduction was larger in men than in women (mean LDL-C difference: -35mg/dL vs. -26mg/dL, when comparing homozygous carriers with non-carriers in men and women, respectively). The relationship between PCSK9-R46L and LDL-C was significantly dependent on sex (P for interaction=7.2e-04). These results demonstrate by complementary approaches that the decrease in LDL-C mediated by PCSK9 inhibition is slightly, but significantly, less marked in women than in men. These data reinforce the need for specific studies to develop sex-specific recommendations for the management of ASCVD in women.

A Systematic Review of the Effects of Plant Compared with Animal Protein Sources on Features of Metabolic Syndrome

Dietary protein may play an important role in the prevention of metabolic dysfunctions. However, the way in which the protein source affects these dysfunctions has not been clearly established. The aim of the current systematic review was to compare the impact of plant- and animal-sourced dietary proteins on several features of metabolic syndrome in humans. The PubMed database was searched for both chronic and acute interventional studies, as well as observational studies, in healthy humans or those with metabolic dysfunctions, in which the impact of animal and plant protein intake was compared while using the following variables: cholesterolemia and triglyceridemia, blood pressure, glucose homeostasis, and body composition. Based on data extraction, we observed that soy protein consumption (with isoflavones), but not soy protein alone (without isoflavones) or other plant proteins (pea and lupine proteins, wheat gluten), leads to a 3% greater decrease in both total and LDL cholesterol compared with animal-sourced protein ingestion, especially in individuals with high fasting cholesterol concentrations. This observation was made when animal proteins were provided as a whole diet rather than given supplementally. Some observational studies reported an inverse association between plant protein intake and systolic and diastolic blood pressure, but this was not confirmed by intervention studies. Moreover, plant protein (wheat gluten, soy protein) intake as part of a mixed meal resulted in a lower postprandial insulin response than did whey. This systematic review provides some evidence that the intake of soy protein associated with isoflavones may prevent the onset of risk factors associated with cardiovascular disease, i.e., hypercholesterolemia and hypertension, in humans. However, we were not able to draw any further conclusions from the present work on the positive effects of plant proteins relating to glucose homeostasis and body composition.