Antihyperlipoproteinemic (antiatherosclerotic) agents

By hyperlipoproteinemia means the conditions under which
Blood plasma increased the content of lipoproteins - carriers of choleste-
Rine and triglycerides. According to generally accepted ideas, an increase
The content of these lipoproteins contributes to the development of atherosclerosis.
Recently, the question of the role of cholesterol in the pathogenesis of athero-
Sclerosis is debatable. However, perennial
Clinical observations suggest that an increase in concentration
Lipoproteins increases the risk of atherosclerosis and,
The use of medicines that are hypolipidemic
Action, leads to a preventive and therapeutic effect when
Treatment of cardiovascular diseases associated with atherosclerosis.
There are several types of lipoproteins participating in the transfer
Cholesterol and phospholipids. The main ones are the Khilomicrons,
Transporting mainly exogenous triglycerides: K lipoprote-
Very low density (VLDL), transferring mostly endogenous
Triglycerides; Low-density lipoproteins (LDL), transporting,
As a rule, cholesterol (cholesterol esters); K high-density lipoproteins
Density (HDL), transporting primarily cholesterol, and so-
The same phospholipids.
Different lipoproteins play an unequal role in the development of athero-
Sclerosis. VLDLs transmit endogenous triglycerides and cholesterol to
Peripheral tissues. From VLDLP are formed LDL transmitting
Cholesterol peripheral tissues, including the walls of the blood-
Vessels, which can contribute to the development of atherosclerosis or
Deepening the process that has already begun. Thus, VLDL and LDL
Are considered as atherogenic lipoproteins. HDL is mobilized
Cholesterol from tissues, including from the walls of blood vessels, and
Cateriatherogenic lipoproteins.
Despite controversial questions about the role of cholesterol in pathogenesis
Atherosclerosis, lipid-lowering agents continue to be used;
In addition, the search for new lipid-lowering drugs is under way.
Optimal drugs are those that lower LDL and single-
Temporarily increasing the concentration of HDL.
The synthesis of lipoproteins and the exchange of cholesterol are complex
Biological processes, and therefore influence them in the
Or to a different extent, substances belonging to different pharmacological
Groups, including drugs regulating the functions of the central nervous system
(Hypnotics, tranquilizers, etc.) and metabolic processes (lipotropic
Means, hormonal preparations.). Apply for this purpose also
Some preparations of plant origin, etc. Some
An antisclerotic effect is provided by Kparidin (see).
An effective hypocholesterolemic agent is K acid
Nicotinic (cm).
Limited use as a hypolipidemic agent,
Have preparations of unsaturated fatty acids (see Linetol, Lipostabil).
[Previously used as a lipid-lowering drug preparation
Ketzemifen is excluded from the nomenclature of medicines as
Effective. The preparation Karahiden is also excluded.].
The main modern antihyperlipoproteinemic (hypocholester-
Rhinemic) drugs are divided into two groups: a) drugs,
Inhibiting mainly the absorption of cholesterol from the intestine
(Cholestyramine, etc.); B) drugs that inhibit biosynthesis and transport
Cholesterol and triglycerides (fibrates, probucol, etc.).
As a rule, lipid-lowering drugs are used in complex
Treatment of diseases accompanied or caused by disorders
Lipid metabolism (especially diseases of the cardiovascular system).
The choice of the drug is determined by the type of hyperlipoproteinemia, clinical
Picture of the disease, efficacy and tolerability of the drug.
Obligatory conditions for the success of pharmacotherapy are compliance
Diet, exclusion of predisposing factors (smoking, violation
Diets, etc.).