Drug Treatment of Type II Hyperlipoproteinemia. Effects on Plasma Lipid and Lipoprotein Levels
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.
KeywordsHigh Density Lipoprotein Cholesterol Total Plasma Cholesterol Lipid Research Clinic Coronary Drug Project Hypolipidemic Agent
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