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HYPERCHOLESTEROLEMIA --- ATHEROSCLEROSIS --- HYPERLIPIDEMIA --- HYPERTRIGLYCERIDEMIA --- LIPOPROTEINS, HDL CHOLESTEROL --- BLOOD --- HYPERCHOLESTEROLEMIA --- ATHEROSCLEROSIS --- HYPERLIPIDEMIA --- HYPERTRIGLYCERIDEMIA --- LIPOPROTEINS, HDL CHOLESTEROL --- BLOOD

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Cardiovascular disease is a major cause of death in the world. A high rate of cholesterol is one of many cardiovascular risk factors. Statins, which are used to treat high rates of cholesterol. are more and more prescribed. In reaction to this ever growing use of statins. Debré and Even debate about their usefulness in primary prevention, ie. to treat people without cardiovascular events but with a risk factor such as hypercholesterolemia. In the r view, it is not necessary to prescribe statins for primary prevention in 90% of cases. In the scientific literature, the benefits in terms of morbidity and mortality have been demonstrated for people with high cardiovascular risk (greater than 5% at 10 years).The evidence is not clear for people with a lower risk. Despite a statistically significant decrease in cardiovascular events, no significant reduction in total mortality was observed. Statins also exert non-lipid effects, called pleiotropic, that have a vascular-protective effect. Statins are relatively tolerated but elevated rate of hepatic enzymes and myalgia are the most frequent side effects. They don’t induce the development of cancers but may increase the risk of developing type II diabetes in people with pre-existing diabetogenic risk factors. Nevertheless, the risk remains below the benefit when the global risk is greater than 5% at 10 years. In conclusion: the effectiveness of statins in secondary prevention or primary prevention in high risk patients, is well established: whereas they should only be prescribed in primary prevention for low risk patients after an individualized analysis of the risk - benefit ratio. Les maladies cardiovasculaires représentent une des premières causes de mortalité dans le monde. Un taux de cholestérol élevé constitue un facteur de risque cardiovasculaire parmi un ensemble de facteurs. Les statines, utilisées pour le traitement de l'hypercholestérolémie, prennent une place de plus en plus importante dans les prescriptions médicales. Face à cette expansion, Even et Debré ont participé à la polémique par la publication d'un livre récent. Ils discutent notamment l'utilité des statines en prévention primaire, c'est-à-dire pour des personnes sans antécédents cardiovasculaires mais présentant des facteurs de risque dont l'hypercholestérolémie. Ces auteurs affirment qu'il est inutile, en prévention primaire, de prescrire une statine dans 90% des cas. Dans la littérature scientifique, les bénéfices en termes de morbi-mortalité ont été démontrés pour les personnes à haut risque cardiovasculaire (supérieur à 5% à 10 ans). Pour les pe_rsonnes à faible risque, les preuves sont moins probantes. En effet, une diminution statistiquement significative des événements cardiovasculaires a été démontrée, cependant, aucune réduction significative de la mortalité totale n'a pu être observée. Les statines exercent aussi des effets non-lipidiques, dits pléiotropiques, ayant un effet vasculo-protecteur. Les statines sont bien tolérées, mais une élévation des enzymes hépatiques et des myalgies sont les effets secondaires les plus fréquents. Un traitement par statines ne modifie pas le risque de survenue de cancers mais peut augmenter le risque de développer un diabète de type II chez les personnes présentant des facteurs de risque diabétogéniques préexistants. Ce risque reste toutefois inférieur au bénéfice lorsque le risque global est supérieur à 5% à 10 ans. Pour conclure, l'efficacité réelle des statines en prévention secondaire ou primaire chez les personnes à haut risque est bien établie. En prévention primaire, chez les personnes à faible risque, elles ne devraient être prescrites qu'après une analyse individualisée de la balance bénéfices - risques.

Hydroxymethylglutaryl-CoA Reductase Inhibitors --- Book Reviews as Topic --- Hypercholesterolemia

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Family Practice --- Hypercholesterolemia --- Practice Guidelines as Topic --- Cholesterol --- therapy --- blood

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APOPROTEINS --- CHOLESTEROL --- HEART DISEASES --- HYPERCHOLESTEROLEMIA --- LIPIDS --- TRIGLYCERIDES --- BLOOD --- BLOOD --- PREVENTION AND CONTROL --- BLOOD --- BLOOD --- APOPROTEINS --- CHOLESTEROL --- HEART DISEASES --- HYPERCHOLESTEROLEMIA --- LIPIDS --- TRIGLYCERIDES --- BLOOD --- BLOOD --- PREVENTION AND CONTROL --- BLOOD --- BLOOD

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Using natural products and developing pharmaceutical drugs are emerging topics to reduce blood cholesterol levels for preventing heart disease and stroke. Covering recent progresses in cholesterol-lowering drugs and therapy, this book describes the natural and pharmaceutical products that are in clinical uses to lower cholesterol and lipids and compares these drugs in responses to different diseases such as homozygous familial hypercholesterolemia, atherosclerosis, cardiovascular disease, and cancer. The relationship between ethnicity and cholesterol-lowering drug responses is also reviewed. Each chapter is a building block for the book, but each individual chapter is also a complete subject package for the readers. Researchers from basic and clinic science interested in lipid and cholesterol metabolism, regulation, and lowering will find this book very useful. Features: - Up-to-date information of the molecular mechanisms of cholesterol lowering, the drugs from natural and pharmaceutical products, and their associated therapeutic strategies in human diseases. - Discussion of the pathogenesis of several human diseases, which are associated with high cholesterol levels and evaluation of the results of different cholesterol-lowering drug treatment in these diseases. - Discussion of the combinations of cancer chemotherapy and cholesterol lowering in potential cancer treatment and cancer prevention by cholesterol-lowering drugs. - Critical analysis of the effect of ethnicity on responses to cholesterol-lowering drug therapy leading to rational dose adjustment of cholesterol-lowering drugs for different people use.

Hypercholesteremia. --- Cholesteremia --- Cholesterolemia --- Hypercholesterolemia --- Hyperlipidemia --- Blood cholesterol --- Medicine --- Cardiology and Cardiovascular Medicine --- Cardiac Electrophysiology --- Health Sciences