Antihyperlipoproteinemic (antiatherosclerotic) agents
Hyperlipoproteinemia refers to conditions in which
plasma levels of lipoproteins - carriers of chole-
rin and triglycerides. According to generally accepted notions, the 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 under discussion. However, perennial
clinical observations indicate that increasing concentration
lipoproteins increases the risk of developing atherosclerosis and, which
action, leads to a preventive and therapeutic effect in
treatment of atherosclerosis-related cardiovascular diseases.
There are several types of lipoproteins involved in the transfer
cholesterol and phospholipids. The main ones are Khylomicrons,
transporting mainly exogenous triglycerides: K lipoprotein
very low density (VLDL), transferring mainly endogenous
triglycerides; low density lipoproteins (LDL) transporting,
usually cholesterol (cholesterol esters); K high lipoproteins
density (HDL), carrying primarily cholesterol, and so
the same phospholipids.
Different lipoproteins play a different role in the development of athero-
sclerosis. VLDLs transmit endogenous triglycerides and cholesterol to
peripheral tissues. VLDL is formed from VLDL, transmitting
peripheral tissue cholesterol, including the walls of the blood
vessels, which may contribute to the development of atherosclerosis or
deepening the process that has already begun. Thus, VLDL and LDL
regarded as K atherogenic lipoproteins. HDL mobilize
cholesterol from tissues, including from the walls of blood vessels, and
They are known as Cantiaterogenic lipoproteins.
Despite controversial questions about the role of cholesterol in pathogenesis
atherosclerosis, lipid-lowering drugs continue to be used;
in addition, a search is underway for new lipid-lowering drugs.
Optimal are drugs that lower LDL and one-
temporarily increasing the concentration of HDL.
Lipoprotein synthesis and cholesterol metabolism are complex
biological processes, therefore, influence them in that
to one degree or another, substances belonging to different pharmacological
groups, including drugs that regulate the functions of the central nervous system
(sleeping pills, tranquilizers, etc.) and metabolic processes (lipotropic
hormonal drugs.). Apply for this purpose also
some herbal preparations, etc. Some
antisplerotic effect has Kparmidin (see).
An effective hypocholesterolemic agent is K acid
Limited use as lipid-lowering agents,
have preparations of unsaturated fatty acids (see. Linetol, Lipostabil).
[Previously used as a hypolipidemic drug
Ketamifen is excluded from the range of medicines as low-efficiency
effective. Carachidine is also excluded.].
The main modern antihyperlipoproteinemic (hypocholeste-
rhinematic) 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 transfer
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 drug is determined by the type of hyperlipoproteinemia, clinical
a picture of the disease, the effectiveness and tolerability of the drug.
The prerequisites for the success of pharmacotherapy are compliance
diet, the exclusion of predisposing factors (smoking, violation