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41 PRACTICAL QUESTIONS AND ANSWERS ABOUT HYPERTENSION AND HYPERCHOLESTEROLEMIA - 2008

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Statins

  • These are the most important drugs used for the reduction of cholesterol, because they are effective and have been subject to analysis over a long period of time. Their side effects are rare. Sometimes they may induce an increase in the enzymes in the blood which are related to liver function (transaminases). A small increase in the levels of these enzymes up to three times the upper normal limit is not a justifiable reason for the discontinuation of the treatment, but an earlier follow up is a reasonable strategy for these patients. Very rarely, statins may cause temporary muscular damage, especially when used in combination with other drugs. Therefore, they should be used only under the guidance of the physician, who has to be aware of all the drugs that are taken by the patient. Statins may decrease LDL-cholesterol by 20 to 60% from the baseline levels before treatment.

Ezetimibe

  • This drug reduces the intestinal absorption of food cholesterol and in this way it lowers the level of "bad" (LDL) cholesterol. It is a mild drug regarding its ability to reduce the level of "bad" LDL-cholesterol, when used alone (monotherapy). However, its combination with a statin may significantly help in the reduction of LDL-cholesterol levels. There are only a few and non significant side effects from this drug.

Fibrates

  • They are used mainly for the reduction of triglyceride levels. They are safe drugs. They should not be used in subjects with renal disease (renal failure). Fibrates reduce "bad" LDL-cholesterol only minimally, but they can increase "good" HDL-cholesterol levels.

Omega-3 fatty acids

  • They decrease triglyceride levels significantly.

WRITING GROUP
G. Stergiou, Chairman
A. Achimastos
E. Andreadis
I. Avramopoulos
M. Elissaf
N. Karatzas
T. Mountokalakis
D. Papadogiannis
K. Siamopoulos
E. Varsamis
K. Vemmos
D. Vlahakos