Ethnic differences in achievement of cholesterol treatment goals

Clark, Luther T.; Maki, Kevin C.; Galant, Ron; Maron, David J.; Pearson, Thomas A.; Davidson, Michael

doi:10.1111/j.1525-1497.2006.00349.x

Cited by 35 publications

(4 citation statements)

References 15 publications

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“…These findings are consistent with prior studies that have reported Blacks with hyperlipidemia are less likely to use statins, and Blacks are also less likely to achieve their goal cholesterol level. [12][13][14] The reasons for Blacks having more than twice the proportion of Whites to neither be on a cholesterol lowering medication nor at their goal LDL are likely similar to the reasons stated for hypertension. However, with statins, side effects are also likely contributing to racial differences.…”

Section: Discussionmentioning

confidence: 93%

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Addressing Stroke Risk Factors in Black and White Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010

et al. 2016

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We found that addressed hypertension and hyperlipidemia in stroke naïve participants were significantly lower in Blacks than Whites. Our observations call attention to areas that require further investigation, such as why Black Americans may not be receiving evidence-based pharmacologic therapy for hypertension and hyperlipidemia or why Black Americans are not at goal blood pressure or goal LDL. A better understanding of this information is critical to preventing stroke and other vascular diseases.

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Section: Discussionmentioning

confidence: 93%

“…8,9 Similar results have been reported for hyperlipidemia, where Blacks are less likely to receive pharmacologic treatment and less likely to reach goal cholesterol levels. [10][11][12][13][14] Stroke survivors are at increased risk of suffering a second stroke. 15…”

Section: Introductionmentioning

confidence: 99%

Addressing Stroke Risk Factors in Black and White Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010

et al. 2016

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“…The different efficacy among regions might result from the difference in race. Studies have reported variations in responses to statin therapy among races [ 21 , 22 ]. It is possible that the relatively greater racial diversity in North America result in a wide confidence interval in the North America group.…”

Section: Discussionmentioning

confidence: 99%

Statin Use and the Risk of Parkinson's Disease: An Updated Meta-Analysis

et al. 2016

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IntroductionIn response to the ongoing debate over the relationship between the use of statins and the risk of Parkinson's disease (PD), we performed a systematic review and meta-analysis of observational studies to examine their association.MethodsWe conducted a review of the literature using electronic databases supplemented by a manual search to identify potentially relevant case-control or cohort studies. Summary relative risk (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Sensitivity and subgroup analyses were also conducted.ResultsEleven studies (five case-control and six cohort) with a total of 3,513,209 participants and 21,011 PD cases were included. Statin use was associated with a lower risk of PD, with a summary RR of 0.81 (95% CI 0.71–0.92). Sensitivity analysis demonstrated the robustness of results. Subgroup analyses showed that neither study design nor study region significantly influenced the effect estimates. However, subgroup studies adjusted for age or sex had a greater inverse association than did unadjusted analyses (age-adjusted RR 0.75, 95% CI 0.60–0.95; age-unadjusted RR 0.86, 95% CI 0.75–0.99 and sex-adjusted RR 0.76, 95% CI 0.59–0.98; sex-unadjusted RR 0.85, 95% CI 0.79–0.92).ConclusionsResults of this systematic review suggest that statin use is associated with a reduced PD risk. However, randomized controlled trials and more observational studies should be performed before strong conclusions are drawn.

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“…They found that statin use was less protective of PD in North America than in other geographies, which is something that may account for some of the conjecture and mixed results that had been published previously. Furthermore, and adding to this complexity in terms of confounding interpretation of statin use in the context of PD epidemiology, Clark et al [ 191 ] found that the frequency of treatment success in dyslipidemia management was significantly lower in African American patients in the USA than in non-Hispanic white patients, while Yood at al [ 192 ] found that African American patients initiating statin therapy are less likely to achieve LDL goals, even after controlling for adherence differences and other factors, and suggested that this group may require different pharmacologic management.…”

Section: Epidemiological Studies On the Use Of Statins And The Risk Omentioning

confidence: 99%

Simvastatin as a Potential Disease-Modifying Therapy for Patients with Parkinson’s Disease: Rationale for Clinical Trial, and Current Progress

Carroll

Wyse

2017

JPD

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Many now believe the holy grail for the next stage of therapeutic advance surrounds the development of disease-modifying approaches aimed at intercepting the year-on-year neurodegenerative decline experienced by most patients with Parkinson’s disease (PD). Based on recommendations of an international committee of experts who are currently bringing multiple, potentially disease-modifying, PD therapeutics into long-term neuroprotective PD trials, a clinical trial involving 198 patients is underway to determine whether Simvastatin provides protection against chronic neurodegeneration. Statins are widely used to reduce cardiovascular risk, and act as competitive inhibitors of HMG-CoA reductase. It is also known that statins serve as ligands for PPARα, a known arbiter for mitochondrial size and number. Statins possess multiple cholesterol-independent biochemical mechanisms of action, many of which offer neuroprotective potential (suppression of proinflammatory molecules & microglial activation, stimulation of endothelial nitric oxide synthase, inhibition of oxidative stress, attenuation of α-synuclein aggregation, modulation of adaptive immunity, and increased expression of neurotrophic factors). We describe the biochemical, physiological and pharmaceutical credentials that continue to underpin the rationale for taking Simvastatin into a disease-modifying trial in PD patients. While unrelated to the Simvastatin trial (because this conducted in patients who already have PD), we discuss conflicting epidemiological studies which variously suggest that statin use for cardiovascular prophylaxis may increase or decrease risk of developing PD. Finally, since so few disease-modifying PD trials have ever been launched (compared to those of symptomatic therapies), we discuss the rationale of the trial structure we have adopted, decisions made, and lessons learnt so far.

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Ethnic differences in achievement of cholesterol treatment goals

Cited by 35 publications

References 15 publications

Addressing Stroke Risk Factors in Black and White Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010

Addressing Stroke Risk Factors in Black and White Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010

Statin Use and the Risk of Parkinson's Disease: An Updated Meta-Analysis

Simvastatin as a Potential Disease-Modifying Therapy for Patients with Parkinson’s Disease: Rationale for Clinical Trial, and Current Progress

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