Prospective randomized comparison between omega-3 fatty acid supplements plus simvastatin versus simvastatin alone in Korean patients with mixed dyslipidemia: lipoprotein profiles and heart rate variability

Kim, Sang-Hyun; Kim, Minkyung; Lee, Hae Young; Kang, Hyun–Jae; Kim, Hyo–Soo

doi:10.1038/ejcn.2010.195

Cited by 21 publications

(7 citation statements)

References 27 publications

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“…In contrast, in an uncontrolled trial of 74 hypercholesterolaemic men, 12 months of atorvastatin (40 mg/day) reduced total cholesterol and LDL-cholesterol, but did not affect time or frequency domain measures of HRV [88]. Similar neutral results have been observed following 6 weeks of simvastatin (20 mg/day) or simvastatin (20 mg/day) plus omega-3 fatty acid supplementation [89]. However, both studies are again confounded by the absence of a control group.…”

Section: Human Studiescontrasting

confidence: 38%

Statins and the autonomic nervous system

Millar

Floras

2013

Clinical Science

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Statins (3-hydroxy-3-methylglutaryl-CoA reductase inhibitors) reduce plasma cholesterol and improve endothelium-dependent vasodilation, inflammation and oxidative stress. A 'pleiotropic' property of statins receiving less attention is their effect on the autonomic nervous system. Increased central sympathetic outflow and diminished cardiac vagal tone are disturbances characteristic of a range of cardiovascular conditions for which statins are now prescribed routinely to reduce cardiovascular events: following myocardial infarction, and in hypertension, chronic kidney disease, heart failure and diabetes. The purpose of the present review is to synthesize contemporary evidence that statins can improve autonomic circulatory regulation. In experimental preparations, high-dose lipophilic statins have been shown to reduce adrenergic outflow by attenuating oxidative stress in central brain regions involved in sympathetic and parasympathetic discharge induction and modulation. In patients with hypertension, chronic kidney disease and heart failure, lipophilic statins, such as simvastatin or atorvastatin, have been shown to reduce MNSA (muscle sympathetic nerve activity) by 12-30%. Reports concerning the effect of statin therapy on HRV (heart rate variability) are less consistent. Because of their implications for BP (blood pressure) control, insulin sensitivity, arrhythmogenesis and sudden cardiac death, these autonomic nervous system actions should be considered additional mechanisms by which statins lower cardiovascular risk.

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Section: Human Studiescontrasting

confidence: 38%

Statins and the autonomic nervous system

Millar

Floras

2013

Clinical Science

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“…Efficacy: The effect of PUFAs in statin-treated subjects is simply addictive in terms of dose-related TG reduction [ 282 , 283 ]. Data from a long-term randomized clinical trial support the concept that combining statins with ω-3 fatty acids seems to further decrease CHD risk by 19% in primary prevention [ 284 ] and CHD mortality by 17% in secondary prevention [ 285 ].…”

Section: Nutraceuticals Combined With Pharmacological Therapymentioning

confidence: 99%

Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel

Cicero¹,

Colletti²,

Bajraktari³

et al. 2017

aoms

261

217

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Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, reaching 31% of deaths in 2012 [1]. In particular, atherosclerosis and ischemic heart disease (IHD) are the main causes of premature death in Europe and are responsible for 42% of deaths in women and 38% in men under 75 years old [2]. The global economic impact of CVD is estimated to have been US $906 billion in 2015 and is expected to rise by 22% by 2030 [3]. Cardiovascular diseases also represent the major cause of disability in developed countries. It has been estimated that their growing burden could lead to a global increase in loss of disability-adjusted life years (DALYs), from a loss of 85 million DALYs in 1990 to a loss of ~150 million DALYs in 2020, becoming a major non-psychological cause of lost productivity [4]. Several risk factors contribute to the etiology and development of CVD; they are divided into those modifiable through lifestyle changes or by taking a pharmacologic treatment (e.g. for hypertension, smoking, diabetes mellitus, hypercholesterolemia) and those that are not modifiable (age, male gender, and family history) [5]. Elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) blood concentrations are the major modifiable risk factors for coronary heart disease (CHD), whereas high concentrations of plasma high-density lipoprotein cholesterol (HDL-C) in certain conditions are considered protective [6]. Moreover, LDL-C remains a fundamental CV risk factor (and a main target of therapy) even when statins are largely used in the general population [7]. An examination of the data of 18 053 participants aged ≥ 20 years who participated in the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2006 showed that the unadjusted prevalence of hypercholesterolemia ranged from 53.2% to 56.1% in United States adults [8]. Differences related to gender and race or ethnicity were observed; in particular, a lower rate of control was found among women than men and lower rates of having a cholesterol check and being told about hypercholesterolemia were reported by African Americans and Mexican Americans than whites [8]. A recent report from the American Heart Association confirmed that in the US only 75.7% of children and 46.6% of adults present targeted TC levels (TC < 170 mg/dl for children and < 200 mg/dl for adults, in untreated individuals) [9]. The pattern is similar in other Western countries [10, 11]

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“…NICE guidelines recommend CVD patients consume at least 7 g of omega 3 fatty acids per week from two to four portions of oily fish in the 3 months following myocardial infarction [54]. Numerous studies have reiterated the synergistic action of Omega oils when combined with medical therapy [55-57]. …”

Section: Lifestyle Modification or Non Pharmacological Management Of mentioning

confidence: 99%

Evidence of Lifestyle Modification in the Management of Hypercholesterolemia

Mannu

Zaman²,

Gupta³

et al. 2013

Current Cardiology Reviews

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Background:Coronary heart disease (CHD) is the leading cause of morbidity and mortality worldwide. The growth of ageing populations in developing countries with progressively urbanized lifestyles are major contributors. The key risk factors for CHD such as hypercholesterolemia, diabetes mellitus, and obesity are likely to increase in the future. These risk factors are modifiable through lifestyle. Objectives: To review current literature on the potential benefit of cholesterol lowering in CHD risk reduction with a particular focus on the evidence of non-pharmacological/lifestyle management of hypercholesterolemia. Methods:Medline/PubMed systematic search was conducted using a two-tier approach limited to all recent English language papers. Primary search was conducted using key words and phrases and all abstracts were subsequently screened and relevant papers were selected. The next tier of searching was conducted by (1) reviewing the citation lists of the selected papers and (2) by using PubMed weblink for related papers. Over 3600 reports were reviewed.Results:Target cholesterol levels set out in various guidelines could be achieved by lifestyle changes, including diet, weight reduction, and increased physical activity with the goal of reducing total cholesterol to <200 mg/dL and LDL-C <100mg/dL. Various dietary constituents such as green tea, plant sterols, soy protein have important influences on total cholesterol. Medical intervention should be reserved for those patients who have not reached this goal after 3 months of non-pharmacological approach. Conclusion:CHD remains as a leading cause of death worldwide and hypercholesterolemia is an important cause of CHD. Non-pharmacological methods provide initial as well as long-term measures to address this issue.

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Prospective randomized comparison between omega-3 fatty acid supplements plus simvastatin versus simvastatin alone in Korean patients with mixed dyslipidemia: lipoprotein profiles and heart rate variability

Cited by 21 publications

References 27 publications

Statins and the autonomic nervous system

Statins and the autonomic nervous system

Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel

Evidence of Lifestyle Modification in the Management of Hypercholesterolemia

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