XV International Symposium on Atherosclerosis.
This symposium is held every three years by the International Atherosclerotic Society, and it carries out the world's largest exhibition of new research and clinical findings on atherosclerosis. This important conference was held from 14 to 18 June 2009 at the Boston school. Atherosclerosis is the fundamental cause of cardiac disease and stroke and together accounts for more than half of the mortality and morbidity of developed countries, is a leading citizen of the United States, ahead of the disease It has been preserved to take millions of lives. This scientific / medical conference took up a broad theme from detection, prevention and treatment of cardiovascular diseases to intervention such as etiology and biology of this disease, lifestyle and medication therapy. First place.
Efficacy of statins ...
One of the most important talks at this conference was to examine the effectiveness of statins and given by Dr. Castain of the Netherlands. Currently, seven versions of atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin and simvastatin can be used clinically. Despite discussions, the vast majority of data to date have found that these drugs have clinical value in some populations. According to Dr. Castellane, "statin treatment significantly improves the outcome of patients with hypercholesterolemia and dyslipidaemia by lowering the plasma level of hypoglycemic cholesterol (LDL-C), whereby primary and secondary Reduce the frequency of cardiovascular events.
However, he also revealed that morbidity and mortality of consecutive coronary heart disease (CHD) are significantly reduced after treatment with these drugs and are not completely eliminated. "
Therefore, these drugs and other drugs can not prevent cardiovascular diseases without combining statin drugs with treatment of this disease, nutrition and exercise and other lifestyle changes and nutritional supplements alone It is used in. Of course, for many people, by making necessary changes to lifestyle practices, there is no need for statin drugs at the beginning, but because there are people with genetic predisposition to dyslipidemia and cardiovascular disease It is not so in the case of.
Dr. Castein outlined large-scale data that examined the effectiveness of statin drugs using various meta-analysis reviews and summarized that even the best outcomes of these drugs still have a high prevalence of disease It was. Reducing LDL - C by statin therapy by 25 - 35% will reduce CV risk by about one - third and the remaining two - thirds will remain "
Thus, although it has been shown that statin drugs are not the answer to the most victims of the people of industrialized countries as monotherapy (ie, used as the only therapeutic agent), the population is potentially It is a useful drug.
This meeting encouraged us to focus on both lifestyle and dietary supplements alone or in combination with statin drugs as a potentially effective treatment for cardiovascular disease (CVD).
Omega-3 fatty acid alone or in combination with a statin drug
At this conference, an amazing amount of research was published about the many benefits of omega-3 fatty acids either alone or in combination with various statin drugs. Large amounts of data concluded that omega-3 fatty acids are effective in improving CVD risk factors and are more effective than statins alone when used in combination with statins.
For example, Dr. Matsuzaki of Yamaguchi University Graduate School of Medicine outlined the results of a large number of people concerning coronary artery prophylaxis of statins (control) or statins (statins) + EPA (eicosapentaenoic acid, omega-3 fatty acids) Disease (CAD) .
This is a randomized combination of EPA + statin (EPA group; n = 1,823) random to statin alone (control group; n = 1,841) in 3,664 patients with established CAD and total cholesterol levels of at least 250 mg / It was a chemical test. The primary endpoint they examined was the major coronary event (MCE). This is important as most studies investigate changes in MCE risk factors (such as changes in cholesterol levels), compared to what is really important, regardless of whether a person suffers from a heart attack. Interestingly, in this large-scale study, "There was no significant difference in serum lipid profile between the two groups during the study". However, "the incidence of MCE in the EPA group was significantly lower than in the control group.
Equally important is the subgroup of people who already had MCE and statin + EPA group had a significantly lower secondary event rate than control / statin only group. On average, in the control group, the proportion of MCE in the statin + omega-3 (EPA) group of 20% or more was 15%. Further encouraging, people who achieve the highest serum EPA level have the lowest MCE rate, so take a fish oil! The researchers concluded, "These results indicate that EPA must be additive to conventional treatments for secondary prevention of CAD."
The above confirms the benefits of omega-3 fatty acids (especially EPA / DHA) and was a literal one among the numerous studies that showed synergistic effects when used in combination with statin drugs.
DHEA levels predict CVD deaths of the elderly.
Dr. Ohlsson of Gothenburg University showed very important data that found the levels of DHEA and / or DHEA-s, which severely predicted cardiovascular disease (CVD) mortality in the elderly. His group saw 2,639 men with a mean age of 75. Following these men for 4.5 years, it was found that the deaths of 328 people correlated strongly with these deaths with the lowest levels of DHEA and DHEA. Most importantly, "The low relevance of DHEA and CVD mortality was still significant after adjustment for smoking, body mass index, diabetes, hypertension". This study found that low serum levels of DHEA predict death from cardiovascular disease in the elderly.
Coenzyme Q 10 study ...
At this conference, there were many studies that examined the effect of CoQ 10 alone or in combination with statin drugs. For the most part we focused on the ability of CoQ 10 to counter the established decline in the CoQ 10 organizational level of patients taking statins. One study that shows that the addition of CoQ 10 has been shown to significantly reduce statin muscle disease (such as pain, weakness, fatigue, etc. of patients using statin drugs) is particularly important. Dr. Fenaco presented the results of a double-blind study evaluating the possibility of CoQ 10 and selenium supplementation in statin-associated muscle disease patients.
60 patients received physical, experimental - including plasma levels of CoQ 10 and selenium, were registered at the beginning and one month and at the end of the study. They showed muscle pain, muscle fatigue, fatigue and convulsions in 40, 21, 22, 18 out of 60 researched, respectively, "All these symptoms were improved in patients treated with CoQ 10 I did .... "However, it was not associated with a reduction in selenium supplementation statin related myopathy. They entered into "supplementation with CoQ 10 that was rejected in reducing the symptoms of statin-related myopathies that may be related not only to the quality of life but also to compliance with statin therapy."
As mentioned above, this study was one of many studies that found that it is beneficial to add CoQ10 to statin therapy. Obviously, CoQ 10 is a "mandatory use" supplement for statin drug people, taking into consideration the long list of benefits and the risk of side effects that are essentially absent.
Niacin research ...
In this conference, vitamin B 3 vitamin niacin was noticed either alone or in combination with statin drug therapy. The benefits of niacin therapy to blood lipids have been well established and extensively covered in LEF magazine pages for many years. We confirmed Niacin as a treatment method for CVD prevention at this meeting. Several studies presented showed that niacin elevates HDL, lower plasma triglyceride (TG) levels, and has other beneficial effects on CVD risk factors in combination with statin drug alone. In this conference, various investigations were conducted to consider niacin released in a timely manner as one way to improve effectiveness and reduce side effects. One lecture outlined "What side effects of NIACIN are barriers to its use? What are the (perceived and actual) side effects given by Dr. McGovern?
According to Dr. McGovern, "side effects of niacin fall into three major categories: skin, metabolism, gastrointestinal, and side effects of the skin is a" flushing "(vasodilation) effect that has many experiences. Red skin, and / or itching. However, Dr. McGovern said, "Niacin 's new sustained release formulation involves the prevention of aspirin and is associated with a 6% to 10% discontinuation of skin side effects in clinical trials."
The less known side effect of high dose niacin therapy is the potential increase in blood glucose. However, on average it is about 5 to 9 mg / dL increase, and the blood glucose usually returns to the baseline value in a relatively short time. For people with normal glucose metabolism (non-diabetic patients), this is not a problem. Even diabetic patients, these have small fluctuations in blood glucose levels and need to be easily managed by dieting or treatment.
Finally, gastrointestinal side effects that are more common in women are heartburn, nausea, diarrhea, and so on. Dr. McGovern found these are generally manageable by taking these vitamins with food and gradually increasing the dose upwards. He concluded, "With adequate education and patient guidance, side effects of niacin should not be a barrier to treatment."
Conclusion.
As with large conferences, the above is an iceberg of proverbs related to a large amount of research and information announced at important meetings. Many nutrients such as garlic, green tea, various polyphenols, plant sterols, L-arginine, etc. have been shown to have the potential benefit of reducing CVD risk. Statins - Other
