Relationship between cholesterol synthesis and intestinal absorption is associated with cardiovascular risk.
Hypercholesterolemia is a major risk factor for cardiovascular disease. The HMG-CoA-reductase inhibitors, statins, reduce plasma cholesterol and, as a consequence, decrease cardiovascular morbidity and mortality. Data from a subgroup analysis of the 4-S Study, however, indicate that patients with high cholesterol absorption may not benefit from statin treatment. Furthermore, there is accumulating evidence that lower hepatic synthesis and higher intestinal absorption markers are associated with increased cardiovascular risk. Therefore, prospective clinical trials are needed to evaluate whether subjects with altered cholesterol homeostasis may benefit from treatment strategies that reduce cholesterol absorption in addition to statin treatment.
Weingärtner
Oliver
O
Klinik für Innere Medizin III, Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse, Gebäude 40, D-66421 Homburg/Saar, Germany. oweingartner@aol.com
Lütjohann
Dieter
D
Böhm
Michael
M
Laufs
Ulrich
U
D000042:Absorption; D000924:Anticholesteremic Agents / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood / Q000378:metabolism*; D003327:Coronary Disease / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000378:metabolism; D006937:Hypercholesterolemia / Q000175:diagnosis* / Q000378:metabolism; D007413:Intestinal Mucosa / Q000378:metabolism*; D008099:Liver / Q000378:metabolism; D010840:Phytosterols / Q000494:pharmacology; D012306:Risk; D013261:Sterols / Q000494:pharmacology
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010840:Phytosterols; D013261:Sterols; D002784:Cholesterol