Advertisement

Drug Treatment of Type II Hyperlipoproteinemia. Effects on Plasma Lipid and Lipoprotein Levels

  • Donald B. Hunninghake
Conference paper

Abstract

The primary indication for the use of drugs to alter plasma lipids and lipo-proteins is the expectation that they may decrease the morbidity and/or mortality associated with the development of arteriosclerotic vascular disease. Various studies with hypolipidemic agents have suggested that either morbidity or mortality associated with coronary heart disease is decreased (Carlson et al. 1977; Dorr et al. 1978; Newcastle Study 1971; WHO Clofibrate Study 1978), but studies such as the Coronary Drug Project (1975) have not demonstrated a beneficial effect. Since there are no studies, universally accepted by the scientific community, which document a reduction in morbidity and mortality, the results of studies currently in progress, such as the Lipid Research Clinic’s Type II Coronary Primary Prevention Trial, are eagerly awaited. Increasing attention has been focussed on the importance of the lipoprotein fractions as potential indicators of future risk of developing coronary heart disease. While age and sex differences may exist, there appears to be a positive correlation between low density lipoprotein cholesterol (LDL-C), and an inverse relationship between high density lipoprotein cholesterol (HDL-C) and risk of developing coronary heart disease (Gordon et al. 1977; Rhoads 1976). These observations indicate that the evaluation of hypolipidemic agents should include their effects on both plasma lipids and lipoproteins. Since the efficacy of many hypolipidemic agents is related to the specific lipoprotein disorder being treated (Hunninghake and Probstfield 1977), hypolipidemic agents should specifically be evaluated in patients with either Type IIa or IIb HLP. This paper reports some of our experiences in the treatment of these two lipoprotein disorders.

Keywords

High Density Lipoprotein Cholesterol Total Plasma Cholesterol Lipid Research Clinic Coronary Drug Project Hypolipidemic Agent 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Carlson LA, Danielson M, Ekberg I, Klintemar B, Rosenhame G (1977) Reduction of myocardial infarction by the combined treatment with clofibrate and nicotinic acid. Atherosclerosis 28: 81–86PubMedCrossRefGoogle Scholar
  2. Coronary Drug Project Research Group (1975) Clofibtate and niacin in coronary heart disease, JAMA 231: 360–381CrossRefGoogle Scholar
  3. Davignon J, Aubry F, Noel C, Lapierre Y, Lafortune M (1971) Heterogeneity of familial hyperlipoproteinemia Type II on the basis of the fasting plasma triglyceride/cholesterol ratio and plasma cholesterol response to chlorophenoxyisobutyrate. Rev Can Biol 30: 307–313PubMedGoogle Scholar
  4. Dorr AE, Gundersen K, Schneider JC, Spencer TW, Martin WB (1978) Colestipol hydrochloride in hypercholesteremic patients — effect on serum cholesterol and mortality. J Chronic Dis 31: 5–14PubMedCrossRefGoogle Scholar
  5. Fellin R, Baggio G, Briani G, Baiocchi MR, Manzata E, Baldo G, Crepald G (1978) Long-term trial with colestipol plus clofibrate in familial hy-percholesteremia. Atherosclerosis 29: 241–249PubMedCrossRefGoogle Scholar
  6. Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber JR (1977) High density lipoprotein as a protective factor against coronary heart disease. Am J Med 62: 707–714PubMedCrossRefGoogle Scholar
  7. Hunninghake DB, Crow L, Isaacson SO, Probstfiel J (1978) Effect of clofibrate and colestipol on lipoprotein levels in Type IIa hyperlipoproteinemia. Fed Proc 37: 257Google Scholar
  8. Hunninghake DB, Probstfield JL (1977) Drug treatment of hyperlipoproteinemia. In: Rifkind B, Levy R (eds) Hyperlipidemia, Diagnosis and Therapy. Grune, StrattonGoogle Scholar
  9. Lipid Research Clinics Program Manual of Laboratory Operations (1975) 1. Lip-id and lipoprotein analyses. NHLBI, NIH, Bethesda, Maryland 20014. DHEW publication No(NIH) 75–628Google Scholar
  10. Newcastle Upon Tyne Region Group of Physicians (1971) Trial of clofibrate in the treatment of ischemic heart disease. Br Med J 4: 767–775CrossRefGoogle Scholar
  11. Rhoads GG, Gulbransen CL, Kagan A (1976) Serum lipoproteins and coronary heart disease in a population study of Hawaii Japanese men. New Engl J Med 294: 293–298PubMedCrossRefGoogle Scholar
  12. WHO Report from the Committee of Principal Investigators (1978) A cooperative trial in the primary prevention of ischemic heart disease using clofibrate. Br Heart J 40: 1069–1118CrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1980

Authors and Affiliations

  • Donald B. Hunninghake

There are no affiliations available

Personalised recommendations