| Disease | RESULTS OF CLINICAL TRIALS CONFIRM THE EFFICACY AND SAFETY OF STATINS FOR CHOLESTEROL LOWERING AND OPEN THE DOOR TO NEW APPROACHES TO REDUCING LOW-DENSITY LIPOPROTEIN (LDL) CHOLESTEROL CONCENTRATIONS. STATINS INHIBIT CHOLESTEROL SYNTHESIS,
REDUCE HEPATIC CHOLESTEROL, ENHANCE EXPRESSION OF LDL RECEPTORS IN LOWER SERUM LDL CHOLESTEROL LEVELS. ANOTHER WAY TO INCREASE LDL RECEPTORS IS TO INHIBIT CHOLESTEROL ABSORPTION, WHICH REDUCES SERUM LDL CHOLESTEROL ABOUT 1/2 OF THAT OBTAINED BY
STATIN THERAPY. ALTHOUGH DIFFERENT AGENTS INHIBIT CHOLESTROL ABSORPTION (E.G. OLESTRA. NEOMYCIN, SURFORMER[AOMA], ACYL COENZYME A ACYLTRANSFERASE INHIBITORS, MICROSOMAL LIPID TRANSFER PROTEIN INHIBITORS. PLANT STEROLS AND STANOLS). THE LATTER
ARE THE MOST PRACTICAL FOR WIDESPREAD USE. STANOLS ACT ENTIRELY WITHIN THE GASTROINTESTINAL TRACT, A FEATURE THAT GREATLY INCREASES THEIR SAFETY. CONSEQUENTLY, THEY ARE A USEFUL ADJUNCT TO DIETARY THERAPY FOR LDL CHOLESTEROL LOWERING. STANOL
ESTERS HAVE OTHER CHARACTERISTICS OF AN IDEAL DIETARY ADJUNCT FOR CHOLESTEROL LOWERING. THEY ARE WELL TOLERATED AND SEMINGLY ARE FREE FROM SIDE-EFFECTS. THEIR POTENTIAL UTILITY AS A DIETARY ADJUNCT FOR LOWERING LDL CHOLESTEROL IS CONSIDERED IN
THE CONTEXT OF PREVENTIVE STRATEGIES, BOTH SECONDARY AND SHORT- AND LONG-TERM PRIMARY PREVENTION, IN HIGH-RISK AND LOW-RISK PERSONS. |