[Prevention and therapy of vascular damage and endothelial dysfunction with hypocholesteremic agents].
Several recent pieces of clinical evidence have demonstrated that reduction of cholesterol levels positively affects outcomes in both primary and secondary prevention of atherosclerotic vascular disease. The mechanism for the beneficial effects of cholesterol-lowering interventions has been attributed to decreased progression or actual regression of plaques as a consequence of reduced circulating LDL concentrations. Other mechanisms can be hypothesized, including a "stabilizing" effect on plaques, which would decrease chances of rupture, and an improvement of endothelial dysfunction, which would slow-down the progression of the disease. This review is aimed at offering an update on such mechanisms. The hypothesis of a direct action of cholesterol-lowering agents, in particular of statins, on endothelial functions, independently of LDL-lowering effects, will be discussed.
De Caterina
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Istituto di Fisiologia Clinica, CNR, Pisa.
Lenzi
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D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control; D004032:Diet; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000517:prevention & control; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008148:Lovastatin / Q000627:therapeutic use; D008297:Male; D008798:Mevalonic Acid / Q000378:metabolism; D008875:Middle Aged; D005082:Physical Exertion; D011322:Primary Prevention; D019821:Simvastatin / Q000627:therapeutic use; D013997:Time Factors
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D002784:Cholesterol; D008148:Lovastatin; D019821:Simvastatin; D008798:Mevalonic Acid
Prevenzione e terapia del danno vascolare e della disfunzione endoteliale con agenti ipo-colesterolemizzanti.