Multifactorial treatment of hypertensive men at high cardiovascular risk and low‐density lipoprotein cholesterol affinity to human arterial proteoglycans

Abstract

The purpose of this work was to examine in an open, randomized parallel-group study whether an intervention programme directed towards hypercholesterolaemia, smoking and diabetes mellitus in treated hypertensive men was associated with less complex formation between low-density lipoprotein (LDL) and human arterial proteoglycans than was the case with usual care. The intervention consisted mainly of non-pharmacological treatment, but drug therapy could be instituted to achieve the treatment goals in the intervention group. The intervention programme was associated with a significant reduction in body mass index, and 46% of the patients were on lipid-lowering medication at the follow-up examination. The net differences were (intervention--usual care): change in serum LDL-cholesterol, -0.48 mmol L-1 (95% confidence interval -0.84 to -0.11 mmol L-1), precipitated LDL-cholesterol, -5.5 micrograms (95% CI -9.0 to -1.1 micrograms). The latter remained after adjustment for the difference in serum LDL-cholesterol between groups. Our conclusion is that the multifactorial risk factor treatment programme was associated with a reduced tendency of LDL to form complexes with human arterial proteoglycans.

Obesity in Older Adults: A Systematic Review of the Evidence for Diagnosis and Treatment

“…We categorized interventions according to counseling frequency, with moderate‐intensity interventions occurring monthly during the first 3 months, low‐intensity interventions occurring less often, and high‐intensity interventions occurring more often. Intensity was high in seven trials (87)(89)(91)(93)(95)(96)(98), moderate to high in one trial (90), moderate in one trial (99), moderate to low in one trial (94), and unreported in one trial (92). We also categorized interventions according to components (diet, exercise, and behavioral techniques).…”

“…Of the four RCTs without high‐intensity interventions (90)(92)(94)(99), only one showed significant weight loss (−1.4 kg) (99). A trial that compared usual care, an intensive intervention, and a less intensive intervention that was adapted to Medicare's reimbursement guidelines found no significant weight loss in the less intensive arm (91).…”

“…A trial that compared usual care, an intensive intervention, and a less intensive intervention that was adapted to Medicare's reimbursement guidelines found no significant weight loss in the less intensive arm (91). Two of the trials showing no significant loss (90)(92) are difficult to interpret because of potential confounding by smoking cessation.…”

“…Of the six RCTs including a behavioral component that reported weight change in older individuals (87)(90)(91)(94)(99)(101), four showed a weight loss that was significant (87)(99)(101) or of borderline significance (91). Of the four RCTs without a clear behavioral component (92)(93)(95)(96), none showed a significant treatment effect on weight loss. The effective dietary interventions typically focused on reducing caloric intake (103), often with reductions in intake of saturated fats and cholesterol (89)(90)(92)(94).…”

“…Of the four RCTs without a clear behavioral component (92)(93)(95)(96), none showed a significant treatment effect on weight loss. The effective dietary interventions typically focused on reducing caloric intake (103), often with reductions in intake of saturated fats and cholesterol (89)(90)(92)(94). Exercise programs typically promoted moderate physical activity.…”