Atorvastatin for lowering lipids

Adams, Stephen P.; Tsang, Michael; Wright, James M

doi:10.1002/14651858.cd008226.pub3

Cited by 68 publications

(22 citation statements)

References 441 publications

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“…Similarly, between 1996–97 and 2006–07 increasing TG levels were found among French adults [ 12 ]. However, a previous review on placebo-controlled randomized controlled trials and uncontrolled before-and-after trials reported an inverse association between the dose of atorvastatin and TG levels [ 31 ]. Our unexpected finding might be due to lifestyle differences between the group of users and non-users of lipid-lowering medication.…”

Section: Discussionmentioning

confidence: 99%

Changes in mean serum lipids among adults in Germany: results from National Health Surveys 1997-99 and 2008-11

et al. 2016

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BackgroundMonitoring of serum lipid concentrations at the population level is an important public health tool to describe progress in cardiovascular disease risk control and prevention. Using data from two nationally representative health surveys of adults 18–79 years, this study identified changes in mean serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) in relation to changes in potential determinants of serum lipids between 1997–99 and 2008–11 in Germany.MethodsSex-specific multivariable linear regression analyses were performed with serum lipids as dependent variables and survey wave as independent variable and adjusted for the following covariables: age, fasting duration, educational status, lifestyle, and use of medication.ResultsMean TC declined between the two survey periods by 13 % (5.97 mmol/l vs. 5.19 mmol/l) among men and by 12 % (6.03 mmol/l vs. 5.30 mmol/l) among women. Geometric mean TG decreased by 14 % (1.66 mmol/l vs. 1.42 mmol/l) among men and by 8 % (1.20 mmol/l vs. 1.10 mmol/l) among women. Mean HDL-C remained unchanged among men (1.29 mmol/l vs. 1.27 mmol/l), but decreased by 5 % among women (1.66 mmol/l vs. 1.58 mmol/l). Sports activity and coffee consumption increased, while smoking and high alcohol consumption decreased only in men. Processed food consumption increased and wholegrain bread consumption decreased in both sexes, and obesity increased among men. The use of lipid-lowering medication, in particular statins nearly doubled over time in both sexes. Among women, hormonal contraceptive use increased and postmenopausal hormone therapy halved over time. The changes in lipid levels between surveys remained significant after adjusting for covariables.ConclusionSerum TC and TG considerably declined over one decade in Germany, which can be partly explained by increased use of lipid-lowering medication and improved lifestyle among men. The decline in serum lipids among women, however, remains unexplained.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2826-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Changes in mean serum lipids among adults in Germany: results from National Health Surveys 1997-99 and 2008-11

et al. 2016

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“…Caucasians has found that the efficacy in plasma LDL-C reduction of simvastatin 20 mg/day is equivalent to atorvastatin 10 mg/day, 34 thus increasing the dose from atorvastatin 10 mg/day to 40 and 80 mg/day should result in addition plasma LDL-C lowering of approximately 12% and 18%, respectively, according to the rule of six. 35 Therefore, switching statins in our study population resulted in a greater reduction in plasma LDL-C than expected in the Caucasians (12% vs 20% for atorvastatin 40 mg/day, and 18% vs 23% for atorvastatin 80 mg/day). These data support the previous finding of heightened response of plasma LDL-C lowering by statin in Asians.…”

Section: Discussionmentioning

confidence: 62%

<p>Efficacy and Safety of Switching from Low-Dose Statin to High-Intensity Statin for Primary Prevention in Type 2 Diabetes: A Randomized Controlled Trial</p>

Thongtang

Piyapromdee

Tangkittikasem

et al. 2020

DMSO

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Introduction: Statin intensification is required in patients who have high-risk for cardiovascular events. However, it is unclear if this is needed in whom plasma LDL-C target was achieved with low-dose statin for primary prevention. We investigated the efficacy and safety of switching from low-dose statin to high-intensity statin among type 2 diabetes (T2D) who had achieved plasma LDL-C <100 mg/dl with low-dose statin treatment. Methods: T2D patients with no atherosclerotic cardiovascular disease who had plasma LDL-C level <100 mg/dl while taking simvastatin ≤20 mg/day were randomized to continue using the same dosage of simvastatin (low-dose statin group; LS) for 12 weeks, or to switch to atorvastatin 40 mg/ day for 6 weeks, and then, if tolerated, to atorvastatin 80 mg/day for 6 weeks (high-intensity statin group; HS). Biochemical test and adverse events were evaluated at baseline, 6 weeks, and 12 weeks. Results: One hundred and fifty patients (76 LS, 74 HS, mean age 58.9±8.9 years, 72% female) were included. The mean baseline plasma LDL-C level on statin was slightly higher in the HS group (71.9±13.6 vs. 68.1±14.2 mg/dl, p=0.09). The HS group had a significantly lower plasma LDL-C level at both 6 and 12 weeks (both p<0.001). Plasma LDL-C <40 mg/dl was found more frequently in the HS group (23.0% vs. 3.9%, p<0.001). Discontinuation of statin due to adverse effects was more frequent in the HS group (5.4% vs. 1.3%, p=0.38 for atorvastatin 40 mg/day, 12.2% vs. 1.3%, p=0.03 for atorvastatin 80 mg/day). No serious adverse events were observed in either group. Conclusion: Switching from low-dose statins to high-intensity statins resulted in a significant reduction in plasma LDL-C levels, and was fairly well tolerated during a 12week study period.

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“…Studies show that atorvastatin reduces total blood cholesterol and LDL-cholesterol in a linear dose-related manner over the commonly prescribed dose range; the effect was higher at lower doses than at higher doses [19]. The results suggested by Ref.…”

Section: Pharmacogenetics Effect Of Rs72658860mentioning

confidence: 84%

A Study to Explore the LDLR Gene Polymorphisms Contribute to Atorvastatin Response in a Sample of Iraqi Population with Atherosclerotic Coronary Artery Disease

Abdulfattah¹,

Abdullah²,

Al-Saffar³

2020

Karbala International Journal of Modern Science

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Genetic factors will determine the higher variability, which found in response to lipid reduction treatment (statins). However, due to ethnicity the frequency and effect of single nucleotide polymorphisms (SNPs) may differ. The main aim of lipid lowering medical treatment is to eventually prevent the endogenous production of cholesterol through inhibition of HMG-CoA reductase, The resulting decrease in hepatocyte cholesterol concentration triggers up-regulation of low-density lipoprotein (LDL)-receptor expression by inducing sterol regulatory element-binding protein (SREBP) 2 cleavage, as SREBP-2 activates LDL receptor transcription. The aim of this study was to evaluate the effects of low density lipoprotein receptor (LDL-R) gene variants (rs200727689; rs72658860) in response to atorvastatin treatment in atherosclerotic coronary artery disease (ACAD) in a sample of Iraqi patients. The genetic polymorphisms of rs200727689 and rs72658860 were studied in patients undergoing coronary angiography (CAG). One hundred Iraqi patients include 52 patients treated with 20mg/day and 48 patients treated with 40mg/day, In addition, 100 apparently healthy subjects were genotype for these SNP by the thermal profile of allelic discrimination methods used Real Time PCR (RT-PCR) assay. A significant increase in A allele frequency (rs200727689) compared with controls for total ACAD patients (43% vs 23.5%; OR= 2.46; 95% C.I: 1.60-3.77; p=0.000). For (rs72658860) SNP, among total patients the A allele also increased the frequency substantially compared with the controls (40.5% vs 23.5%; P=0.0003; OR= 2.22; 95% C.I: 1.44-3.41). In the patients who were treated with atorvastatin, SNP rs72658860 AA genotype significantly affected the response of atorvastatin in dose 20mg compared with 40mg. The result showed in AA genotype of (rs200727689) SNP a reduction in TC concentrations (277.55±108.38 vs 326.99±63.56) and LDL-C concentrations (198.33±100.0 vs 250.01±62.52) in sera compared with GG genotype in patients treated with 20 mg atorvastatin, although, none in all parameters statistically significant differences.

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Atorvastatin for lowering lipids

Cited by 68 publications

References 441 publications

Changes in mean serum lipids among adults in Germany: results from National Health Surveys 1997-99 and 2008-11

Changes in mean serum lipids among adults in Germany: results from National Health Surveys 1997-99 and 2008-11

<p>Efficacy and Safety of Switching from Low-Dose Statin to High-Intensity Statin for Primary Prevention in Type 2 Diabetes: A Randomized Controlled Trial</p>

A Study to Explore the LDLR Gene Polymorphisms Contribute to Atorvastatin Response in a Sample of Iraqi Population with Atherosclerotic Coronary Artery Disease

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