[Effects of lipid lowering measures on coronary perfusion].
Secondary intervention trials in coronary heart disease have unequivocally proven the effectiveness of lipid-lowering medication in addition to dietary means. Orderly application of available drugs leads to reductions in LDL cholesterol and triglycerides accompanied by increases in HDL cholesterol. Specifically, LDL cholesterol lowering is associated with clinical benefits in coronary heart disease, it reduces the necessity of hospitalization and interventions, and leads to significant reductions in coronary as well as in overall mortality. Besides morphological changes of coronary vessels like regression or retarded progression of plaques, lipid-lowering was shown to normalize endothelial dysfunction associated with hyperlipidemia. Restoring endothelial function and improving coronary perfusion may be one of the factors responsible for the huge clinical benefits in secondary intervention trials as compared to the modest morphological changes. As the fact of lipid-lowering rather than the means by which it is achieved is of specific importance, dietary means have to precede and then accompany an eventual additional drug treatment.
Steinmetz
A
A
Abteilung Kardiologie, Philipps Universität Marburg.
Maisch
B
B
Noll
B
B
D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000628:therapy*; D003326:Coronary Circulation / Q000502:physiology*; D018752:Diet, Fat-Restricted; D004730:Endothelium, Vascular / Q000503:physiopathology; D006801:Humans; D006949:Hyperlipidemias / Q000503:physiopathology / Q000628:therapy*; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D008055:Lipids / Q000097:blood; D016896:Treatment Outcome
D000960:Hypolipidemic Agents; D008055:Lipids