scholarly journals Comparison of three cohorts of COVID-19 patients with different severity: exposure to antihypertensive, antidiabetic and lipid-lowering agents

2021 ◽  
Author(s):  
Judit Riera-Arnau ◽  
Antònia Agustí ◽  
Marta Miarons ◽  
Adrian Sanchez-Montalva ◽  
Yolima Cossio ◽  
...  
Keyword(s):  
Drug Exposure ◽  
Current Knowledge ◽  
University Hospital ◽  
Lipid Lowering ◽  
Multivariate Logistic Regression Model ◽  
Intensive Care Treatment ◽  
Channel Blockers ◽  
Multiple Imputations ◽  
Lipid Lowering Agents ◽  
Reference Cohort

Aim: The association between COVID-19 disease severity and certain medicines for the treatment of chronic diseases is currently under discussion. We herein evaluated if previous exposure to antihypertensive, hypoglycaemic, and lipid-lowering drugs increases the risk of poorer COVID-19 outcomes. Methods: We performed a retrospective study on three cohorts of COVID-19 adult patients between March 2020 and May 2020 at the Vall d’Hebron University Hospital. Information relating to the patient lifestyle, comorbidities, and chronic exposures was retrieved from primary healthcare electronic records. Three cohorts were examined, namely patients who had died or required intensive care treatment (ICU/Death [ICU-D] Cohort), patients who required hospitalisation (Hospitalisation [HOSP] Cohort), and patients who only attended the emergency department (Emergencies [EM] Cohort). Descriptive statistics and a multivariate logistic regression model were used to investigate associations with drug exposure, where EM was employed as the reference cohort. Results: We included 1,778 patients: 417 (23.5%) from the ICU-D Cohort, 1,052 (59.2%) from the HOSP Cohort, and 309 (17.4%) from the EM Cohort. After multiple imputations and data adjustment by potential confounders, no statistically significant association was observed between the COVID-19 severity and the use of antihypertensives, hypoglycaemic agents, or lipid-lowering agents, with the exception of calcium channel blockers (CCB) (ICU-D Cohort: OR 2.23; CI 95% [1.03–4.83]; P = 0.042). Conclusions: Most results on lifestyle characteristics and comorbidities related to COVID-19 severity were in agreement with current knowledge, although some associated factors are nowadays a matter of controversy and further investigation is required.

Cholesterol Testing by General Practitioners in Grampian: Patterns and Outcomes

1996 ◽  
Vol 41 (3) ◽  
pp. 78-82 ◽  
Author(s):  
B.H. Smith ◽  
V. Vranjkovic ◽  
S.R. McEwan ◽  
L.D. Ritchie
Keyword(s):  
Current Knowledge ◽  
Clinical Chemistry ◽  
Chemistry Laboratory ◽  
Lipid Lowering ◽  
Biochemical Tests ◽  
Wide Range ◽  
Prescription Rates ◽  
Lipid Lowering Agents ◽  
Cholesterol Testing

Initiation, distribution, concomitants and follow-up of cholesterol testing were studied in Grampian. Data were examined for 4979 patients, representing all patients in one year from those general practices who made exclusive use of the clinical chemistry laboratory for cholesterol testing. A random sample of 215 patients was studied in further detail. Age and sex distribution, results of cholesterol tests and their follow-up, nature and results of associated biochemical tests, test initiation, testing rates by practice, and prescription rates of lipid lowering agents by practice were measured. Cholesterol testing was mostly in line with current knowledge of cardiovascular risk, and associated with further cardiovascular and biochemical assessment. There was a 90-fold range in practice cholesterol testing rates, and a similarly wide range in prescription rates of lipid lowering agents; there was a significant correlation between these. Rates and results of follow-up testing suggests a “rule of halves” for cholesterol testing.

scholarly journals Hypocholesterolemia and Statins in Multiple Myeloma

2021 ◽  
pp. 8-10
Author(s):  
Irfan Yavaşoğlu ◽  
Atakan Turgutkaya
Keyword(s):  
Multiple Myeloma ◽  
Current Knowledge ◽  
Lipid Lowering ◽  
Current Therapy ◽  
Beneficial Effects ◽  
Plasma Cell Disorder ◽  
Lipid Lowering Agents ◽  
Low Cholesterol ◽  
Beneficial Approach ◽  
Cell Disorder

Statins are lipid-lowering agents. They also have immunomodulatory, anti-inflammatory, anti-angiogenic, and anti-proliferative functions. In this context, they are demonstrated to have beneficial effects on mortality in several malignancies including esophageal, breast, lung, liver, pancreatic, endometrial, and colorectal cancers. Multiple myeloma is considered as an incurable plasma cell disorder with current therapy; however due to the current knowledge about the correlation between cholesterol-lowering agents and myeloma; it’s suggested to have lower mortality rates for patients using statins.  Patients with multiple myeloma usually have a low cholesterol level which is often underestimated by clinicians. Hereby we aimed to summarize the myeloma-hypocholesterolemia relationship and emphasize the importance of statins as an inexpensive and beneficial approach for these patients.

scholarly journals Treatments for NAFLD: State of Art

2021 ◽  
Vol 22 (5) ◽  
pp. 2350
Author(s):  
Alessandro Mantovani ◽  
Andrea Dalbeni
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Current Knowledge ◽  
Lipid Lowering ◽  
Major Health Problem ◽  
Alcoholic Fatty Liver ◽  
History Of ◽  
Glucagon Like Peptide 1 ◽  
Lipid Lowering Agents

Non-alcoholic fatty liver disease (NAFLD) is to date the most common chronic liver disease in clinical practice and, consequently, a major health problem worldwide. It affects approximately 30% of adults in the general population and up to 70% of patients with type 2 diabetes (T2DM). Despite the current knowledge of the epidemiology, pathogenesis, and natural history of NAFLD, no specific pharmacological therapies are until now approved for this disease and, consequently, general strategies have been proposed to manage it. They include: (a) lifestyle change in order to promote weight loss by diet and physical activity, (b) control of the main cardiometabolic risk factors, (c) correction of all modifiable risk factors leading the development and progression of advanced forms of NAFLD, and (d) prevention of hepatic and extra-hepatic complications. In the last decade, several potential agents have been widely investigated for the treatment of NAFLD and its advanced forms—shedding some light but casting a few shadows. They include some glucose-lowering drugs (such as pioglitazone, glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose co-transporter-2 (SGLT-2) inhibitors), antioxidants (such as vitamin E), statins or other lipid lowering agents, bile and non-bile acid farnesoid X activated receptor (FXR) agonists, and others. This narrative review discusses in detail the different available approaches with the potential to prevent and treat NAFLD and its advanced forms.

scholarly journals Current Evidence and Future Perspectives on Pharmacological Treatment of Calcific Aortic Valve Stenosis

2020 ◽  
Vol 21 (21) ◽  
pp. 8263 ◽  
Author(s):  
Maristella Donato ◽  
Nicola Ferri ◽  
Maria Giovanna Lupo ◽  
Elisabetta Faggin ◽  
Marcello Rattazzi
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Current Knowledge ◽  
Present Report ◽  
Lipid Lowering ◽  
Heart Valve Disease ◽  
Current Evidence ◽  
Medical Need ◽  
Health Care Burden ◽  
Lipid Lowering Agents

Calcific aortic valve stenosis (CAVS), the most common heart valve disease, is characterized by the slow progressive fibro-calcific remodeling of the valve leaflets, leading to progressive obstruction to the blood flow. CAVS is an increasing health care burden and the development of an effective medical treatment is a major medical need. To date, no effective pharmacological therapies have proven to halt or delay its progression to the severe symptomatic stage and aortic valve replacement represents the only available option to improve clinical outcomes and to increase survival. In the present report, the current knowledge and latest advances in the medical management of patients with CAVS are summarized, placing emphasis on lipid-lowering agents, vasoactive drugs, and anti-calcific treatments. In addition, novel potential therapeutic targets recently identified and currently under investigation are reported.

scholarly journals Secondary Pharmacotherapeutic Prevention among German Primary Care Patients with Peripheral Arterial Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Uwe Müller-Bühl ◽  
Gunter Laux ◽  
Joachim Szecsenyi
Keyword(s):  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Population Based ◽  
Lipid Lowering ◽  
Channel Blockers ◽  
Prescription Rates ◽  
Primary Care Patients ◽  
Peripheral Arterial ◽  
Lipid Lowering Agents

Background. The aim of the study was to determine the secondary preventive medical supply of patients with peripheral arterial disease (PAD) in German primary care.Methods and Results. A population-based case control study was conducted using electronic medical records of patients extracted from the CONTENT primary care database of Heidelberg, Germany, between April 2007 and March 2010. The prescription rates of cardiovascular medication among symptomatic PAD patients were analysed by means of the ATC classification and compared with those of patients with cardiovascular disease (CVD). 479 cases with PAD and 958 sex- and age-matched control CVD patients were identified. PAD patients showed significantly lower prescription rates for cardiac agents (21.7% versus 37%),β-blockers (50.1% versus. 66.2%), and lipid-lowering agents (50.3% versus 55.9%) compared to CVD patients. In contrast, significantly more prescriptions of antidiabetic agents (28.2% versus 20.3%), particularly insulin and analogues (12.5% versus 8%), and calcium channel blockers (29.2% versus 24.3%) were found in PAD patients. Low-dose aspirin use among both PAD and CVD patients was underestimated, as it is available without a prescription.Conclusions. Optimal pharmacotherapeutical care of patients with PAD requires more intensive cardioprotective medication in primary care settings.

scholarly journals Targeting Metabolic Dysfunction for the Treatment of Mood Disorders: Review of the Evidence

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 819
Author(s):  
Brett D. M. Jones ◽  
Salman Farooqui ◽  
Stefan Kloiber ◽  
Muhammad Omair Husain ◽  
Benoit H. Mulsant ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Structural Changes ◽  
Current Knowledge ◽  
Lipid Lowering ◽  
Current Evidence ◽  
Metabolic Dysfunction ◽  
Specific Symptom ◽  
Novel Treatments ◽  
Lipid Lowering Agents ◽  
The Impact

Major depressive disorder (MDD) and bipolar disorder (BD) are often chronic with many patients not responding to available treatments. As these mood disorders are frequently associated with metabolic dysfunction, there has been increased interest in novel treatments that would target metabolic pathways. The objectives of this scoping review were to synthesize evidence on the impact on mood symptoms of lipid lowering agents and anti-diabetics drugs, while also reviewing current knowledge on the association between mood disorders and dyslipidemia or hyperglycemia. We propose that metabolic dysfunction is prevalent in both MDD and BD and it may contribute to the development of these disorders through a variety of pathophysiological processes including inflammation, brain structural changes, hormonal alterations, neurotransmitter disruptions, alteration on brain cholesterol, central insulin resistance, and changes in gut microbiota. Current evidence is conflicting on the use of statins, polyunsaturated fatty acids, thiazolidinediones, glucagon-like peptide agonists, metformin, or insulin for the treatment of MDD and BD. Given the paucity of high-quality randomized controlled trials, additional studies are needed before any of these medications can be repurposed in routine clinical practice. Future trials need to enrich patient recruitment, include evaluations of mechanism of action, and explore differential effects on specific symptom domains such as anhedonia, suicidality, and cognition.

scholarly journals On the Mode of Action of Lipid-lowering Agents

1971 ◽  
Vol 246 (2) ◽  
pp. 348-358 ◽  
Author(s):  
Michael E. Maragoudakis ◽  
Hilda Hankin
Keyword(s):  
Mode Of Action ◽  
Lipid Lowering ◽  
Lipid Lowering Agents

scholarly journals Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders

2021 ◽  
Vol 18 (4) ◽  
pp. 1692
Author(s):  
Akylbek Sydykov ◽  
Argen Mamazhakypov ◽  
Abdirashit Maripov ◽  
Djuro Kosanovic ◽  
Norbert Weissmann ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
High Altitude ◽  
Clinical Experience ◽  
Current Knowledge ◽  
Hypoxic Pulmonary Vasoconstriction ◽  
Treatment Options ◽  
Right Heart Failure ◽  
Channel Blockers ◽  
The Right ◽  
Extensive Clinical Experience

Alveolar hypoxia is the most prominent feature of high altitude environment with well-known consequences for the cardio-pulmonary system, including development of pulmonary hypertension. Pulmonary hypertension due to an exaggerated hypoxic pulmonary vasoconstriction contributes to high altitude pulmonary edema (HAPE), a life-threatening disorder, occurring at high altitudes in non-acclimatized healthy individuals. Despite a strong physiologic rationale for using vasodilators for prevention and treatment of HAPE, no systematic studies of their efficacy have been conducted to date. Calcium-channel blockers are currently recommended for drug prophylaxis in high-risk individuals with a clear history of recurrent HAPE based on the extensive clinical experience with nifedipine in HAPE prevention in susceptible individuals. Chronic exposure to hypoxia induces pulmonary vascular remodeling and development of pulmonary hypertension, which places an increased pressure load on the right ventricle leading to right heart failure. Further, pulmonary hypertension along with excessive erythrocytosis may complicate chronic mountain sickness, another high altitude maladaptation disorder. Importantly, other causes than hypoxia may potentially underlie and/or contribute to pulmonary hypertension at high altitude, such as chronic heart and lung diseases, thrombotic or embolic diseases. Extensive clinical experience with drugs in patients with pulmonary arterial hypertension suggests their potential for treatment of high altitude pulmonary hypertension. Small studies have demonstrated their efficacy in reducing pulmonary artery pressure in high altitude residents. However, no drugs have been approved to date for the therapy of chronic high altitude pulmonary hypertension. This work provides a literature review on the role of pulmonary hypertension in the pathogenesis of acute and chronic high altitude maladaptation disorders and summarizes current knowledge regarding potential treatment options.

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