Dujovne C A
Lipid and Arteriosclerosis Prevention Clinic, University of Kansas Medical Center, Kansas City 66103.
Clin Cardiol. 1991 Feb;14(2 Suppl 1):I48-52. doi: 10.1002/clc.4960141308.
Available data on results of lipid-acting drug trials investigating the prevention or treatment of atherosclerotic cardiovascular disease have conclusively shown that: (a) The beneficial results may not be specific for a given pharmacological group of drugs (i.e., niacin, resins, fibrates, reductase inhibitors). (b) For lipid-acting drugs, the extent of cardiovascular benefit may be related to the extent of the effect on blood lipids. (c) Some drugs may be acting by affecting factors not necessarily related to blood lipid levels (i.e., calcium channel blockers and antioxidants of low-density lipoproteins. (d) The differences in endpoints begin to appear after the second year of intervention. (e) The effects on atherosclerosis can be measured objectively by modern angiographic techniques. (f) Patient's signs and symptoms of disease can be beneficially modified. (g) The long-term safety record of the tested drugs seems adequate. (h) The risk-benefit ratio justifies long-term drug treatment of dyslipidemias in patients not responding to life-style intervention.
(a) 有益结果可能并非特定于某一给定药理学类别的药物（即烟酸、树脂类、贝特类、还原酶抑制剂）。(b) 对于脂质作用药物，心血管益处的程度可能与对血脂的影响程度相关。(c) 一些药物可能通过影响不一定与血脂水平相关的因素起作用（即钙通道阻滞剂和低密度脂蛋白抗氧化剂）。(d) 干预第二年之后，终点差异开始显现。(e) 现代血管造影技术可客观测量对动脉粥样硬化的影响。(f) 患者的疾病体征和症状可得到有益改善。(g) 受试药物的长期安全性记录似乎良好。(h) 风险效益比证明，对生活方式干预无反应的血脂异常患者进行长期药物治疗是合理的。
