Abstract:
The treatment of patients with high cardiovascular risk and mixed hyperlipidemia is difficult due to multiple quantitative and qualitative lipid abnormalities. The priority is to reduce LDL-c levels, for which statins are the drug of choice. Despite the benefits of statins, the residual cardiovascular risk is very high in patients with atherogenic dyslipidemia. To reduce this risk, we also need to control non-HDL cholesterol levels, decreasing triglyceride levels and increasing HDL-c levels. To achieve these objectives and lifestyle changes, the use of combined therapy is often required. Fibrates are drugs that can be used in combination with statins to reduce this residual risk. Fenofibrate is well tolerated in combination with statins. The fixed combination of pravastatin/ fenofibrate has been shown to have complementary benefits in the atherogenic lipid profile in general. The combination is well tolerated and is indicated in patients with high risk and mixed hyperlipidemia who have controlled or are close to their objectives for LDL-c levels, using 40-mg pravastatin in monotherapy. The beneficial eff ect of the combination on LDL-c levels is minimal and is primarily observed in non-HDL cholesterol, triglycerides and HDL-c. The combination of pravastatin 40 and fenofibrate 160 can provide a considerable clinical benefit to patients with high risk and mixed atherogenic dyslipidemia, to patients with LDL-c levels that are controlled or near the objectives for decreasing their residual risk of lipid origin and is especially useful for patients with type 2 diabetes, obesity and combined metabolic syndrome and familial hyperlipidemia.
摘要:
由于多个定量和定性脂质异常,高心血管风险和混合性高脂血症患者的治疗困难。首要任务是降低LDL-c水平,他汀类药物是首选药物。尽管他汀类药物的好处,动脉粥样硬化型血脂异常患者的残余心血管风险非常高。为了降低这种风险,我们还需要控制非高密度脂蛋白胆固醇水平,降低甘油三酯水平和增加HDL-c水平。为了实现这些目标和生活方式的改变,通常需要使用联合治疗。贝特类药物是可以与他汀类药物联合使用以降低这种残留风险的药物。非诺贝特与他汀类药物联合使用时耐受性良好。普伐他汀/非诺贝特的固定组合已被证明在动脉粥样硬化脂质分布中具有互补的益处。该组合具有良好的耐受性,适用于控制或接近LDL-c水平目标的高风险和混合性高脂血症患者。在单一疗法中使用40毫克普伐他汀。组合对LDL-c水平的有益效果是最小的,主要在非HDL胆固醇中观察到。甘油三酯和HDL-c。普伐他汀40和非诺贝特160的组合可以为高风险和混合性动脉粥样硬化血脂异常的患者提供相当大的临床益处。LDL-c水平控制或接近降低其脂质来源残余风险的目标的患者,对2型糖尿病患者特别有用,肥胖和合并代谢综合征和家族性高脂血症。