Treatment of Essential Hyperlipidæmia

Jepson, E.; Fahmy, Maurice; Torrens, PatriciaE.; Billimoria, J. D.; Maclagan, N. F.

doi:10.1016/s0140-6736(69)90860-5

Cited by 18 publications

(3 citation statements)

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“…Previous investigators using cholestyramine in adults have either restricted saturated fat intake Fallon and Woods, 1968), or have kept their patients on a normal diet (Blacket et al, 1964;Jepson et al, 1969). Our studies show that the degree of reduction of serum cholesterol does not depend on the dietary fat intake, and the fact that such a marked reduction can be achieved and sustained without the need for dietary modification represents a significant advance in the management of children with familial hypercholesterolaemia.…”

Section: Discussionmentioning

confidence: 61%

“…Treatment of adults with familial hypercholesterolaemia using 12 to 36 g cholestyramine daily in 3 or 4 doses has resulted in reductions in serum cholesterol varying between 15 to 30% in different series (Howard et al, 1966;Jepson et al, 1969;Fredrickson and Levy, 1970). Marked individual variations in the response to therapy have been reported and the larger reductions have not always been associated with larger doses of the drug.…”

Section: Discussionmentioning

confidence: 99%

“…To compensate for this loss, hepatic synthesis of bile acids from cholesterol increases and serum cholesterol falls. Cholestyramine has been used for the treatment of adults with hypercholesterolaemia (Blacket, Woodhill, and Brown, 1964;Hashim and Van Itallie, 1965;Howard, Brusco, and Furman, 1966;Fallon and Woods, 1968;Jepson, et al, 1969;Fredrickson and Levy, 1970) and is probably the most effective agent currently available. There is 370 little information, however, on the use of cholestyramine in children with hypercholesterolaemia.…”

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confidence: 99%

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Use of cholestyramine in treatment of children with familial hypercholesterolaemia

West¹,

Lloyd²

1973

Archives of Disease in Childhood

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Use of cholestyramine in treatment of children with familial hypercholesterolaemia

West¹,

Lloyd²

1973

Archives of Disease in Childhood

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Reduced or modified dietary fat for preventing cardiovascular disease

Hooper

Summerbell

Higgins

et al. 2000

Cochrane Database of Systematic Reviews

118

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BACKGROUND: Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol), but their effects on important health outcomes are less clear. OBJECTIVE: To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. METHODS:Search methods: For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase, were searched through to June 2010. References of Included studies and reviews were also checked. Selection criteria: Trials fulfilled the following criteria: 1) randomized with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) adult humans with or without cardiovascular disease, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Data collection and analysis: Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. MAIN RESULTS: This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction -which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women). There were no clear effects of dietary fat changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). This did not alter with sub-grouping or sensitivity analysis. Few studies compared reduced with modified fat diets, so direct comparison was not possible. AUTHORS' CONCLUSIONS: The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear.The abstract is available free-of-charge from: http://onlinelibrary. wiley.com/

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Reduced or modified dietary fat for preventing cardiovascular disease

Hooper

Summerbell

Thompson

et al. 2011

Cochrane Database of Systematic Reviews

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Background Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol), but their effects on important health outcomes are less clear. Objectives To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. Search methods For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, were searched through to June 2010. References of Included studies and reviews were also checked. Selection criteria Trials fulfilled the following criteria: 1) randomised with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) adult humans with or without cardiovascular disease, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Data collection and analysis Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. Main results This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women). There were no clear effects of dietary fat changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). This did not alter with sub-grouping or sensitivity analysis. Few studies compared reduced with modified fat diets, so direct comparison was not possible. Authors’ conclusions The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear.

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Treatment of Essential Hyperlipidæmia

Cited by 18 publications

References 11 publications

Use of cholestyramine in treatment of children with familial hypercholesterolaemia

Use of cholestyramine in treatment of children with familial hypercholesterolaemia

Reduced or modified dietary fat for preventing cardiovascular disease

Reduced or modified dietary fat for preventing cardiovascular disease

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