Hyperlipoproteinemia medical therapy: Difference between revisions

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===[[Hypertriglyceridemia medical therapy | Pharmacotherapy]]===
===[[Hypertriglyceridemia medical therapy | Pharmacotherapy]]===
===[[Omega-3 Fatty Acid]]s===
===[[Omega-3 fatty acids | Omega-3 Fatty Acids]]===


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Revision as of 22:56, 26 October 2012

Lipoprotein Disorders Microchapters

Patient Information

Overview

Causes

Classification

Hyperlipoproteinemia
Hypolipoproteinemia

Treatment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hyperlipidemia requires early detection, careful evaluation and aggressive treatment with combination of therapeutic lifestyle changes and lipid-lowering drug therapies to reduce the risk of cardiovascular and cerebrovascular complications.

Medical Therapy

Medical Therapy in Adults

Medical Therapy in Children and Adolescents

  1. Drug therapy
  2. Adjuvant therapies

Pharmacotherapy

Omega-3 Fatty Acids

Drug Mechanisms of Benefit Dosage Advantages Side Effects Contraindications
Omega-3 fatty acids

↓ hepatic lipogenesis
↓ plasma lipoprotein lipase activity
↑ hepatic mitochondrial and peroxisomal beta-oxidation
Inhibition of acyl CoA:1,2-diacylglycerol acyltransferase enzyme
EPA and DHA are poor enzyme substrates for triglyceride synthesis in liver and inhibits esterification of other fatty acids.

3 g/day of EPA and DHA[1]

VLDL[2], [3]
TG by ≥50%

Bleeding, at high doses
Fishy smell, can be reduced by

  • freezing of medication
  • trying different formulation
  • taking medication with food

Nausea

Hypersensitivity

(↑ - Increase, ↓ - Decrease)

Trial supportive data

AIM HIGH study

References

  1. Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B; et al. (2006). "n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review". Am J Clin Nutr. 84 (1): 5–17. PMID 16825676.
  2. Nestel PJ, Connor WE, Reardon MF, Connor S, Wong S, Boston R (1984). "Suppression by diets rich in fish oil of very low density lipoprotein production in man". J Clin Invest. 74 (1): 82–9. doi:10.1172/JCI111422. PMC 425187. PMID 6736254.
  3. Durrington PN, Bhatnagar D, Mackness MI, Morgan J, Julier K, Khan MA; et al. (2001). "An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia". Heart. 85 (5): 544–8. PMC 1729738. PMID 11303007.

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