Atherosclerosis is a chronic process characterized by inflammation and the progressive accumulation of inflammatory cells and lipids in the blood vessel wall, resulting in narrowing of the blood vessel’s circumference. Treatment of people with dyslipidemia aims to reduce the risk of developing atherosclerotic disease and prevent major adverse cardiovascular events (MACE). The results of previous studies indicated that lipoprotein(a) (Lp(a)) is a critical causal factor in the estimated risk of developing a cardiovascular (CV) incident even after achieving desirable low-density lipoprotein (LDL) cholesterol levels. Lp(a) is a low-density lipoprotein particle, like LDL cholesterol. The levels of Lp(a) in plasma are genetically determined. Lp(a) catabolism is still controversial. The pathogenic potential of Lp(a) can be divided into three categories: promotion of plaque formation, thrombogenicity, and proinflammatory effects. Lp(a) levels above the 75th percentile reduced the risk of aortic valve stenosis and myocardial infarction, whereas higher levels (above 90th percentile) were associated with an increased risk of heart failure. However, no hypolipidemic agents have been approved for targeted use in patients with high Lp(a) levels. There are insufficient randomized controlled trials assessing CV outcomes that would support the evidence that current treatment options, which effectively lower Lp(a) levels, also effectively prevent CV event. However, according to some studies, there is strong evidence that better CV outcome is one of the benefits of such therapy. The results of ongoing clinical trials are eagerly awaited.
Objective: This study aimed to examine the contents of home pharmacies and medication use, as well as storage and disposal habits in urban and rural households in Serbia. Material and Methods: This prospective research was conducted within 70 households in Novi Sad (urban setting) and Laćarak (rural setting) from October 1, 2015 to January 15, 2016. The data were collected using a standardized questionnaire, as well as by direct examination of drugs stored in households. Results: The most common groups of drugs stored were cardiovascular drugs, drugs for the nervous system, antirheumatic products and antimicrobials. A high percentage of drugs for the alimentary tract were found stored in Laćarak, while drugs for the respiratory tract were discovered in Novi Sad. Prescription only medications (POMs) made up 69.7% of all medications in Laćarak and 60.6% in Novi Sad. POMs were purchased independently in high amounts (13.2% in Laćarak and 9.1% in Novi Sad). Presence of expired medications was higher in Laćarak (12.0%) than Novi Sad (5.8%). Over two-thirds of the households stored medications properly; however, only 10.0% of respondents reported the proper disposal of unused medications. Conclusion: The structures of home pharmacies in Novi Sad and Laćarak differ, which implies different healthcare needs. The practice of self-medicating was noted both in Novi Sad and Laćarak. While Laćarak residents rely more on the advice of friends and family, Novi Sad residents buy medicine mostly without any consultation. Medications in both environments are stored properly in the majority of households, but mostly disposed of improperly together with household waste.
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