Diseases of the cardiovascular system, pathology of the organs of the circulatory system occupy a leading position in medical statistics around the world. Every year, the proportion of people suffering from heart ailments is growing. A high mortality rate is explained by many factors - unbalanced diet, lack of stress tolerance, polluted environment, genetic aspect.
Among cardiovascular diseases, the main ones are coronary heart disease and arterial hypertension (high blood pressure). The main prerequisite for the development of these ailments is hypercholesterolemia, which is also called hyperlipoproteinemia. Such a factor in the development of diseases is often detected with the progressive development of these.
Cholesterol - benefit or harm?
Very many medical luminaries ten years ago, the only cause of heart disease was considered an imbalance of cholesterol in the body. Today, after numerous studies and evidence, it became clear that in the body of sick people and predisposed to the development of heart ailments, it is necessary to monitor not only the specific indicator of cholesterol, but also triglycerides, and phospholipids, and lipoproteins, which play not the last role in ensuring the smooth functioning of cardio vascular system.
The main carriers of these elements in the human body are nevertheless lipoproteins. They are divided into LDL - low density lipoproteins that transport cholesterol to cells; VLDL - very low density lipoproteins that transport triglycerides; HDL - lipoproteins that transport cholesterol and phospholipids.
LDL and VLDL transfer cholesterol into tissue cells and to a greater extent put it on the walls of blood vessels, but HDL does not allow it to settle there.
Thus, the former are harmful, and the latter are beneficial. Therefore, the cause of cardiovascular disease does not lie in cholesterol. To some extent, it is useful for the human body as a component of the correct metabolic processes. You should know that just our body produces cholesterol itself, and in larger quantities than a person absorbs with food.
In connection with this discovery, doctors in the treatment of cardiovascular diseases did not reduce the cholesterol level in the blood itself, but rather regulate the disturbed imbalance between LDL, VLDL and HDL, that is, inhibit the first and increase the second.
An imbalance is called in medical terms a lipid metabolism disorder. It can be regulated with the help of drugs included in the lipid-lowering group.
Hypolipidemic drugs - what is it?
In the domestic pharmaceutical market, many lipid-lowering drugs are offered. Lipid-lowering drugs are drugs that normalize lipid metabolism. How? How hypolipidemic agents work, namely, what is the mechanism of their effect on the sick person’s body, is discussed below.
Features of lipid-lowering drugs
This group includes medicines of varying degrees of effectiveness. They primarily affect the overall indicator of cholesterol, lower it, but at the same time take care that the proportions of LDL and HDL are adjusted in the body.
Studying lipid-lowering drugs, the mechanism of their action, in particular, makes it clear that lowering cholesterol is achieved by inhibiting the processes responsible for its absorption in the intestine, creating a barrier to the release of fatty acids from adipose tissue, activating the processes of cholesterol catabolism and inhibiting lipid synthesis in the liver .
Various mechanisms of influence on the level of beneficial and harmful cholesterol are the main feature of drugs, depending on which they are included in certain subgroups of lipid-lowering drugs. This will be discussed below.
The choice of a specific drug for treatment depends on the type of diagnosed hyperlipoproteinemia. So, five types are distinguished: in the first, there is an increase in blood cholesterol, in the second - an increase in LDL, in the third - the appearance of pathological lipoproteins, in the fourth - an increase in VLDL, in the fifth - an increase in cholesterol and VLDL.
In each case, a certain complex therapy is provided.
Hypolipidemic agents are also applicable for the prevention of complex cardiovascular diseases, in particular, heart attacks and atherosclerosis. The use of these drugs in practice has helped to reduce the mortality rate among people suffering from cardiovascular ailments. A large evidence base of medical bodies is confirmed by the fact that lipid-lowering drugs are effective in the treatment of hypertension of various origins.
Medicines of this group have long been used in European countries for the elimination of cardiovascular diseases, while they appeared on the domestic market relatively recently, and a large number of them are doubtful.
Today it is possible to purchase lipid-lowering drugs of both domestic and foreign production. Since not all sick people have the same picture of the diagnosis, everyone receives individual recommendations on the use of a particular medication from this group.
Main classification
If we consider the generalized lipid-lowering drugs, their mechanism of action is understandable. However, each specific drug has its own characteristics. Before describing them, let's see how the classification, compiled by experienced specialists, distributed lipid-lowering drugs.
So, drugs sold in modern pharmacies that affect the level of cholesterol in the body can be divided into three types:
- depleting reserves of cholesterol in the liver, inhibiting the absorption process thereof in the intestine;
- inhibiting the synthesis of lipoproteins;
- Accelerating metabolic processes and removing lipids from the body.
The first type includes sequestrants of bile acids. The second - statins, fibrates, nicotinic acid. To the third - "Probucol", choleretic drugs.
As noted above, lipid-lowering drugs are a special group of drugs that can increase the presence of beneficial cholesterol and inhibit harmful cholesterol.
Sequestrants of bile acids: characteristics, examples
Hypolipidemic drugs of this subgroup according to pharmacological characteristics belong to anion-exchange resins. They contain in their composition such an element as a chlorine ion. They are not absorbed in the intestine, they absorb bile acids in exchange for chlorine and excrete them naturally.
Since there is a shortage of bile acids in the intestines, fats are poorly absorbed, including the absorption of cholesterol by the intestines. Thus, the body begins to respond to its lack and reproduces HDL, which transport cholesterol from blood vessels to the liver.
Examples of sequestrants are medications such as Cholestyramine and Cholestipol, as well as Cholestid.
Statins: characteristics, examples
These are lipid-lowering drugs, the mechanism of action of which is to block the work of the enzyme involved in the synthesis of cholesterol. They create conditions for a significant reduction in the reproduction of cholesterol in the liver, due to which there is a decrease in its concentration in the blood.
It is generally accepted that statins are the ones that can prevent heart attacks and strokes. These medications not only lower cholesterol, but also effectively relieve vascular inflammation. Thinning the blood, they inhibit the development of atherosclerosis, dilate blood vessels at high pressure, contributing to its rapid normalization. Do not allow atherosclerotic plaques to grow.
Statins, in turn, are lipid-lowering drugs that are divided into four generations of effectiveness.
First-generation statins affect weaker cholesterol lower than newer drugs. The drugs Lovastatin, Simvastatin, Pravastatin belong to this group of drugs. They are made from penicillin mushrooms and are considered natural in origin.
Second-generation statins are drugs with a prolonged mechanism of action on the sick person’s body due to the increased concentration of the active component in the blood. They include a drug such as "Fluvastatin."
Third-generation statins are an improved version of the first and second generations, which regulates the balance of bad cholesterol and healthy in the body, and also reduces triglycerides. The most common example is Atorvastatin.
The fourth-generation statins are innovative developments that practically do not cause side effects and are characterized by increased effectiveness. The main drug of this subgroup is Rosuvastatin.
Statins of the second, third and fourth generations are drugs of synthetic origin.
What is the most effective hypolipidemic agent from the group of statins and does not cause any side effects? There are none among them. All statins are capable of causing certain harm to the human body by side effects, along with its high ability to relieve vascular inflammation and remove harmful cholesterol from the body.
The most popular and acceptable are still the fourth-generation statins. But if we take into account the fact that each core and hypertension has its own, individual picture of the disease and its predisposition to complications, then the drugs are prescribed exclusively by the attending doctor, and not just taken, because the patient wants it so much.
Fibrates: characteristics, examples
These hypolipidemic agents (classification classifies them in the fourth group), which effectively cope with the task of lowering LDL and triglycerides in the blood. They activate lipoprotein lipases in blood plasma and liver. Due to this, TG is split off from LDL and HDL is reproduced, which remove cholesterol from the vessels.
Despite the fact that these are effective lipid-lowering drugs, a comparative characteristic with other groups of such drugs showed that they are significantly inferior to statins in terms of utility.
Examples of fibrates are drugs such as clofibrate, gemfibrozil, bezafibrat, fenofibrat.
Nicotinic acid, its properties
Very often, cores and hypertonics pay special attention to vitamins. Let's find out the drug, which vitamin belongs to lipid-lowering drugs. This is just nicotinic acid. It is called in the medical field Vitamin PP, or B3.
Nicotinic acid exhibits its lipid-lowering properties when taking a dose greater than the human body requires as a vitamin. This drug inhibits the synthesis of VLDL in the liver, thereby decreasing the concentration of LDL and TG, with TG more than cholesterol.
Patients take this drug in a strictly defined specialist dose; nicotinic acid cannot be prescribed on its own. Each skipping admission is fraught with deterioration in the treatment of heart disease.
"Probukol." The properties
This medication is an antioxidant. It moderately affects the indicators of beneficial and harmful cholesterol in the blood. In particular, this hypolipidemic drug works in a slightly different way compared to the above. It does not increase the concentration of HDL, but reduces it. Activation of non-receptor pathways for the withdrawal of LDL from the blood when taking "Probucol" and is thus a lipid-lowering property.
This drug is more experimental than therapeutic, but nevertheless its use in medical practice takes place. Many properties of Probucol have not yet been studied. It is well tolerated by patients, but, without a solid evidence base for its benefits, doctors still prefer to prescribe other hypolipidemic agents to their patients for long-term and safe therapy.
What lipid-lowering drugs are more effective?
This article discusses lipid-lowering drugs. What it is is now clear. We repeat once again that these medications help to remove harmful cholesterol from the body and increase the concentration of healthy in the blood. If the proportion of these substances is violated, then the patient is at risk of developing heart attacks, strokes and atherosclerosis.
The main indications for the use of lipid-lowering drugs are a genetic predisposition for the development of atherosclerosis, hyperlipoproteinemia.
You should know that complex therapy does not provide for the simultaneous administration of several lipid-lowering drugs. The luminaries of medicine today do not distinguish the best hypolipidemic agents from the total mass. Their pharmacology varies greatly. In each case, a specific drug is prescribed.
If you take into account the quality before using the means of this group, then more confidence is still caused by foreign drugs. But it is also worth noting that the domestic market today is filled with all kinds of generics of foreign production, which are also no less high quality than the original. The undoubted advantage is that they are cheaper.
Not so high quality is not in low efficiency, but in the delayed action of the drug itself.
Hypolipidemic drugs are medications that can fight a high mortality rate in a group of patients suffering from cardiovascular diseases or predisposed to their development.
Now you know what are lipid-lowering drugs, indications for admission are discussed above. We don’t report anything about the specific dosage of these drugs, since it is individual for each patient, it is prescribed only by the attending physician after a full diagnosis of the patient’s body.
In search of lipid-lowering drugs, people are faced with a situation where pharmacists recommend purchasing hepatoprotective drugs. What is common between them?
Hepatoprotective drugs are applicable in the treatment of the liver. Since the lipid-lowering effect is associated with metabolic processes in which cholesterol is involved and which occur in the liver, many hepatoprotective drugs are characterized by a lipid-lowering effect. And this, in turn, means that the UDC of hepatoprotective and lipid-lowering drugs can be identical, often we are talking about one drug that is applicable in the treatment of both the liver and cardiovascular diseases.
The theoretical description of the lipid-lowering properties of a new generation of drugs is not as complicated as the practice of taking them. Achieved positive effect does not mean that these drugs are safe for the general condition of patients.
Absolutely all groups and subgroups of drugs with lipid-lowering properties can cause serious side effects. The main one is an increase in blood sugar concentration. Therefore, they are contraindicated for most diabetics. But still, a certain group of patients with diabetes are undergoing therapy with the appointment of these. In this case, the attending physician assesses the possible risks of a worsening of the patient's condition.
Each person is an individually acting organism with its own characteristics, which are both genetically incorporated and physically acquired. Hypolipidemic drugs of any group from the above classification are prescribed to patients after a thorough examination of the picture of ill health.
Self-medication is unacceptable. Only a competent physician competent in matters of metabolic processes can give a specific recommendation about which drug is more acceptable at a certain stage of the disease.
You also need to understand that these drugs can be taken as the main therapy in the treatment of a progressive illness, as well as for prevention. In each case, a specific dose is prescribed, which acts sparingly on the body of the person taking it for a specific purpose (to stabilize their well-being).
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