Hypertriglyceridemia is a theoretical risk factor for CHD because of the increased production of atherogenic chylomicron and VLDL remnants, the inverse relationship present between serum triglyceride and HDL, the possible resultant increase in LDL attributable to remnant-reduced hepatic LDL-receptors as well as the formation of more dense and, therefore, more atherogenic LDL, and to the interaction between serum triglyceride and the fibrinolytic/coagulation system. However, most clinical trials that have found hypertriglyceridemia to be a risk factor for CHD do not include other CHD risk factors in their analyses. Therapeutic intervention to lower serum triglyceride with diet, exercise, and/or drugs is definitely recommended in the treatment and/or prevention of pancreatitis; however, the role of triglyceride-lowering to reduce CHD risk remains controversial.
Significant reductions in serum cholesterol concentrations can be achieved with cholesterol-lowering interventions. However, the benefits associated with cholesterol reduction may not outweigh the risks in all patients with hypercholesterolemia. Cholesterol-lowering interventions should be recommended with caution in patients at increased risk of cancer, stroke, and depression. Caution should also be used when recommending fibric acid derivatives for patients with existing CHD.
Iodinated glycerol is used as a mucolytic agent in the treatment of chronic obstructive pulmonary disease. Its efficacy is controversial, and reports of its toxicity are substantial. We report a case of chronic iodine poisoning in a patient with chronic obstructive pulmonary disease following 20 years of iodinated glycerol therapy. Reevaluation of the long-term use of this medication is encouraged. Monitoring long-term recipients of iodinated glycerol therapy for chronic iodine poisoning and drug-induced thyroid abnormalities is recommended.
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