Medical management of hyperlipidemia and the role of probucol.
Recent experimental and epidemiologic evidence has dispelled all doubts about the need to treat patients with hyperlipidemia. Therapy should focus on 3 areas: control of concomitant risk factors for atherosclerosis, reduction of lipid levels through diet and, if response to diet proves inadequate, administration of lipid-lowering agents. There are 4 categories of first-line drugs: resins, fibrates, nicotinic acid and probucol. Probucol has a sustained effect, additive to that of a lipid-lowering diet; it can reduce total serum cholesterol and cause xanthoma regression even in patients with receptor-defective homozygous familial hypercholesterolemia. It is effective when used alone and has an additive effect when combined with resins or nicotinic acid. Compared with many other lipid-lowering medications, it is well tolerated. Although the combination of probucol and clofibrate may cause a significant decrease in high density lipoproteins, there is no evidence that this decrease carries any adverse consequences for the underlying disease process.
Davignon
J
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D000328:Adult; D001161:Arteriosclerosis / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D002792:Cholestyramine Resin / Q000627:therapeutic use; D002994:Clofibrate / Q000627:therapeutic use; D003084:Colestipol / Q000627:therapeutic use; D005260:Female; D015248:Gemfibrozil; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D006938:Hyperlipoproteinemia Type II / Q000188:drug therapy; D006951:Hyperlipoproteinemias / Q000178:diet therapy / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000627:therapeutic use; D010421:Pentanoic Acids / Q000627:therapeutic use; D010636:Phenols / Q000627:therapeutic use*; D011341:Probucol / Q000627:therapeutic use*; D012306:Risk
D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D010421:Pentanoic Acids; D010636:Phenols; D002792:Cholestyramine Resin; D009525:Niacin; D002994:Clofibrate; D003084:Colestipol; D011341:Probucol; D015248:Gemfibrozil