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Питание, атерогенные гиперлипидемии и статины
Питание, атерогенные гиперлипидемии и статины
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Аннотация
В статье рассматриваются вопросы диетических подходов к коррекции атерогенных нарушений липидного спектра крови. Обозначены цели антиатеросклеротического питания и его основные антиатерогенные составляющие. Показана важность модификации жирового состава потребляемой пищи для профилактики сердечно-сосудистых заболеваний. В статье рассматриваются тактика назначения статинов и подходы к правильному выбору их адекватных доз (на примере аторвастатина) в первичной и вторичной профилактике ишемической болезни сердца.
Ключевые слова: питание, гиперлипидемия, ишемическая болезнь сердца, аторвастатин.
Key words: diet, hyperlipidemia, coronary heart disease, atorvastatin.
Ключевые слова: питание, гиперлипидемия, ишемическая болезнь сердца, аторвастатин.
________________________________________________
Key words: diet, hyperlipidemia, coronary heart disease, atorvastatin.
Полный текст
Список литературы
1. Оганов Р.Г. Факторы риска и профилактика сердечно-сосудистых заболеваний. Качество Жизни. Медицина. 2003; 2: 10–15.
2. Оганов Р.Г., Масленникова Г.Я. Смертность от сердечно-сосудистых и других хронических неинфекционных заболеваний среди трудоспособного населения России. Кардиоваск. тер. и профилакт. 2002; 3: 4–8.
3. Lloyd-Jones DM, Hong Y, Labarthe D et al. Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction. The American Heart Association`s Strategis Impact Goal Through 2020 and Beyond. Circulation 2010; 121: 586–613.
4. McGee DL, Read DM, Yano K et al. Ten-year incidence of coronary heart in the Honolulu Heart Program: relationship to nutrient intake. Am J Epidemiol 1984; 119: 667–76.
5. Keys A, Menotti A, Karvonen MJ et al. The diet and 15 years death rate in the serum countris study. Am J Epidemiol 1986; 124: 903–15.
6. VII всероссийский конгресс «Здоровое питание населения России». 2003. Материалы конгресса.
7. Киселева Н.Г., Перова Н.В., Олферьев А.М., Митяев А.А. и др. Оценка «пищевого риска» дислипидемий с помощью опросника, адаптированного для врачебной практики. Кардиология. 1998; 10: 91–5.
8. Hjermann I, Byre KV, Holme I, Leren P. Effect of diet and smoking intervention on the incidents of coronary heart disease. Report from the Oslo Study Group of a randomized trial in healthy men. Lancet 1981; 12: 1303–10.
9. Longeril de M, Renand S, Mamelle N et al. Mediterranean alpha-linoleic acid-rich diet in secondary prevention of CHD. Lancet 1994; 343; 1454–9.
10. Coronary heart disease: reducing the risk. The scientific background for primary and secondary prevention of coronary heart disease. A worldwide view prepared by International Task Force for Prevention of Coronary Heart Disease in cooperation with the International Atherosclerosis Society. Nutr Metab Cardiovasc Dis 1998; 8: 205–72.
11. Grundy SM. Dietary treatment of hyperlipidemia. I Hypercholesterolemia and atherosclerosis. Pathogenesis and prevention edited by D.Steinberg, JM.Olefsky. New York. Churchill Livingstone 1987: 169–93.
12. Kris-Etherton PM et al. Summury of the scientific conference on dietary fatty acids and cardiovascular health: conference summary from the nutrition committee of the American Heart Association. Circulation 2001, 103: 1034–9.
13. Hu FB, Manson JA, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. Am J Clin Nutr 2001; 20 (1): 5–19.
14. Hu FB, Stampfer MJ, Manson JA et al. Dietary saturated fat and their food sourced in relation to the risk of coronary heart disease in women. Am J Clin Nutr 1999; 70: 1001–8.
15. Nestel P. Saturated and trans fatty acids and coronary heart disease. Eur Heart J 1999; 1 (Suppl. S): S19–S23.
16. Mensink, Zock еt al. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 2003; 77: 1146–55.
17. Keys A, Anderson JT, Grande F. Serum cholesterol response to changes in the diet. IV Particular saturated fatty acids in the diet. Metabolism 1965; 14: 776–87.
18. Mamo JCL, Yu KCW, Elsegood CL et al. Is atherosclerosis exclusively a post-prandial phenomenon? Clin Exp Pharmacop Physiol 1997; 24: 288–93.
19. Karpe F, Steiner G, Uffelman K et al. Postprandial lipoproteins and progression of coronary atherosclerosis. Atherosclerosis 1994; 106: 83–97.
20. Patsch JR, Miesenbock G, Hopferwieser T et al. Relation of triglyceride metabolism and coronary artery disease: studies in the postprandial state. ArteriosclerThromb 1992; 12: 1336–45.
21. Stampfer MJ, Krauss RM, Blanche PJ et al. A Prospective Study of triglyceride level, low-density lipoprotein particle diameter, and risk of myocardial infarction. JAMA 1996; 276: 882–8.
22. Бубнова М.Г., Оганов Р.Г. Нарушенная толерантность к пищевым жирам и ее значение в атеротромбогенезе. Тер. арх. 2004; 1: 73–8.
23. Perova NV, Metelskaya VA, Bubnova MG et al. Association of apo E polymorphism with nutritional and drug-induced changes in lipoproteins. Eur J Lab Med 1997; 5: 1–5.
24. Katan MB. Trans fatty acids and plasma lipoproteins. Nutrition Reviews 2000, 58: 188–91.
25. Oomen CM, Ocke MC at al. Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study. Lancet 2001; 357: 746–51.
26. Din JN et al. Omega 3 fatty acids and cardiovascular disease – fishing for natural treatment. BMJ 2004; 328: 30–5.
27. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico. Lancet 1999; 354: 447–55.
28. Kris-Etherton PM. Monounsaturated fatty acids and risk of coronary heart disease. Circulation 1999; 100: 1253–8.
29. European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2003; 24 (17): 1601–10.
30. Grundy SM, Cleeman JI, Merz CN et al. National Heart, Lung, and Blood Institute; American College of Cardiology Foundation; American Heart Association Implications of recent clinical trial for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004; 110: 227–39.
31. Бубнова М.Г., Перова Н.В., Аронов Д.М. Синдром нарушенной толерантности к атерогенным пищевым жирам: клинико-биохимические проявления, метод выявления. Медицинская технология. 2010. Разрешение ФС № 2010/073 от 16 марта 2010 г.
32. Chin-Dusting J PF, Shaw JA Lipids and atherosclerosis: clinical management of hypercholesterolaemia. Exp Opin Pharmacother 2001; 2: 419–30.
33. Naoumova R, Dunn S, Rallidis L et al. Prolonged inhibition of cholesterol synthesis explains the efficacy of atorvastatin. J Lipid Res 1997; 38: 1496–500.
34. Jones P, Kafonek S, Laurora I et al. Comparative dose efficacy study of atorvastatin versus simvastatin, pravastatin, lovastatin and fluvastatin in patients with hypercholesterolemia (The Curves study). Am J Cardiol 1998; 81: 582–7.
35. Eastaugh JL, Calvert MJ, Freemantle N Highlighting the need for better patient care in stable angina: results of the international Angina Treatment Patterns (ATP) Survey in 7074 patients. Family Practice 2005; 22: 43–50.
36. Бубнова М.Г., Аронов Д.М., Оганов Р.Г., Рудоманов О.Г и др. (от имени исследователей). Клиническая характеристика и общие подходы к лечению пациентов со стабильной стенокардией в реальной практике. Российское исследование ПЕРСПЕКТИВА (ч. I). Кардиоваск. тер. и профилакт. 2010; 6: 47–56.
37. Sever P, Dahlöf B, Poulter N et al. Prevention of coronary and store events with atorvastatin in hypertensive pations who have average or lower-than-average cholesterol concentrations, in the Ango-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOTT-LLA): a multicentre randomized controlled trial. Lancet 2003; 363: 1149–58.
38. Schwartz GG, Olsson AG, Ezekowitz MD et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 2001; 285: 1711–8.
39. Cannon CP et al. Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes. Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis in Myocardial Infarction 22. N Engl J Med 2004; 350: 1495–504.
40. Pitt B, Waters D, Brown WV, van Boven AJ et al. for Atorvastatin versus Revascularization Treatment Investigators. Aggressive lipid-lowing therapy compared with angioplasty in stable coronary artery disease. N Engl J Med 1999; 341: 70–6.
41. Wijns W, Kolh P, Danchin N et al. Guidelines on myocardial revascularization. ESC /EACTS Guidelines. Eur Heart J 2010; 31: 2501–55.
42. Koren NJ Statin use in a «real-world» clinical setting: aggressive lipid lowering compared with usual care in the Aggressive Lipid-Lowering Initiation Abates New Cardiac Events (ALLIANCE) trial. Am J Medicine 2005; 118 (12A): 165–215.
43. LaRosa JC, Grundy SM, Waters DD, Shear C et al. Treating to New Targets (TNT) Investigators. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005; 352 (14): 1425–35.
44. Pedersen TR, Faergeman O, Kastelein JJP et al. High-Dose Atorvastatin vs Usual-Dose Simvastatin for Secondary Prevention After Myocardial Infarction. The IDEAL Study: A Randomized Controlled Trial JAMA 2005; 294: 2437–45.
45. Athyros VG et al. Effect of atorvastatin on high density lipoprotein cholesterol and its relationship with coronary events: a subgroup analysis of the GREek Atorvastatin and Coronary heart- disease Evaluation (GREACE) Study. Curr Med Res Opin 2004; 20 (5) 627–37.
46. Patti G, Pasceri V, Colonna G et al. Atorvastatin Pretreatment Improves Outcomes in patients with acute coronary syndromes undergoing early percutaneous coronary intervention. Results of the ARMYDA-ACS Randomized Trial. J Am Coll Cardiol 2007; 49: 1272–8.
47. Sciascio GD, Patti G, Pasceri V. Efficacy of atorvastatin reload in patients on chronic statin therapy undergoing percutaneous coronary intervention: Results of the ARMYDA-RECAPTURE (Atorvastatin for reduction of myocardial damage during angioplasty) Randomized Trial. J Am Coll Cardiol 2009; 54: 558–65.
48. Amarenco P et al High-Dose Atorvastatin after Stroke or Transient Ischemic Attack. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL). N Eng J Med 2006; 355: 549–59.
2. Оганов Р.Г., Масленникова Г.Я. Смертность от сердечно-сосудистых и других хронических неинфекционных заболеваний среди трудоспособного населения России. Кардиоваск. тер. и профилакт. 2002; 3: 4–8.
3. Lloyd-Jones DM, Hong Y, Labarthe D et al. Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction. The American Heart Association`s Strategis Impact Goal Through 2020 and Beyond. Circulation 2010; 121: 586–613.
4. McGee DL, Read DM, Yano K et al. Ten-year incidence of coronary heart in the Honolulu Heart Program: relationship to nutrient intake. Am J Epidemiol 1984; 119: 667–76.
5. Keys A, Menotti A, Karvonen MJ et al. The diet and 15 years death rate in the serum countris study. Am J Epidemiol 1986; 124: 903–15.
6. VII всероссийский конгресс «Здоровое питание населения России». 2003. Материалы конгресса.
7. Киселева Н.Г., Перова Н.В., Олферьев А.М., Митяев А.А. и др. Оценка «пищевого риска» дислипидемий с помощью опросника, адаптированного для врачебной практики. Кардиология. 1998; 10: 91–5.
8. Hjermann I, Byre KV, Holme I, Leren P. Effect of diet and smoking intervention on the incidents of coronary heart disease. Report from the Oslo Study Group of a randomized trial in healthy men. Lancet 1981; 12: 1303–10.
9. Longeril de M, Renand S, Mamelle N et al. Mediterranean alpha-linoleic acid-rich diet in secondary prevention of CHD. Lancet 1994; 343; 1454–9.
10. Coronary heart disease: reducing the risk. The scientific background for primary and secondary prevention of coronary heart disease. A worldwide view prepared by International Task Force for Prevention of Coronary Heart Disease in cooperation with the International Atherosclerosis Society. Nutr Metab Cardiovasc Dis 1998; 8: 205–72.
11. Grundy SM. Dietary treatment of hyperlipidemia. I Hypercholesterolemia and atherosclerosis. Pathogenesis and prevention edited by D.Steinberg, JM.Olefsky. New York. Churchill Livingstone 1987: 169–93.
12. Kris-Etherton PM et al. Summury of the scientific conference on dietary fatty acids and cardiovascular health: conference summary from the nutrition committee of the American Heart Association. Circulation 2001, 103: 1034–9.
13. Hu FB, Manson JA, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. Am J Clin Nutr 2001; 20 (1): 5–19.
14. Hu FB, Stampfer MJ, Manson JA et al. Dietary saturated fat and their food sourced in relation to the risk of coronary heart disease in women. Am J Clin Nutr 1999; 70: 1001–8.
15. Nestel P. Saturated and trans fatty acids and coronary heart disease. Eur Heart J 1999; 1 (Suppl. S): S19–S23.
16. Mensink, Zock еt al. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 2003; 77: 1146–55.
17. Keys A, Anderson JT, Grande F. Serum cholesterol response to changes in the diet. IV Particular saturated fatty acids in the diet. Metabolism 1965; 14: 776–87.
18. Mamo JCL, Yu KCW, Elsegood CL et al. Is atherosclerosis exclusively a post-prandial phenomenon? Clin Exp Pharmacop Physiol 1997; 24: 288–93.
19. Karpe F, Steiner G, Uffelman K et al. Postprandial lipoproteins and progression of coronary atherosclerosis. Atherosclerosis 1994; 106: 83–97.
20. Patsch JR, Miesenbock G, Hopferwieser T et al. Relation of triglyceride metabolism and coronary artery disease: studies in the postprandial state. ArteriosclerThromb 1992; 12: 1336–45.
21. Stampfer MJ, Krauss RM, Blanche PJ et al. A Prospective Study of triglyceride level, low-density lipoprotein particle diameter, and risk of myocardial infarction. JAMA 1996; 276: 882–8.
22. Бубнова М.Г., Оганов Р.Г. Нарушенная толерантность к пищевым жирам и ее значение в атеротромбогенезе. Тер. арх. 2004; 1: 73–8.
23. Perova NV, Metelskaya VA, Bubnova MG et al. Association of apo E polymorphism with nutritional and drug-induced changes in lipoproteins. Eur J Lab Med 1997; 5: 1–5.
24. Katan MB. Trans fatty acids and plasma lipoproteins. Nutrition Reviews 2000, 58: 188–91.
25. Oomen CM, Ocke MC at al. Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study. Lancet 2001; 357: 746–51.
26. Din JN et al. Omega 3 fatty acids and cardiovascular disease – fishing for natural treatment. BMJ 2004; 328: 30–5.
27. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico. Lancet 1999; 354: 447–55.
28. Kris-Etherton PM. Monounsaturated fatty acids and risk of coronary heart disease. Circulation 1999; 100: 1253–8.
29. European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2003; 24 (17): 1601–10.
30. Grundy SM, Cleeman JI, Merz CN et al. National Heart, Lung, and Blood Institute; American College of Cardiology Foundation; American Heart Association Implications of recent clinical trial for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004; 110: 227–39.
31. Бубнова М.Г., Перова Н.В., Аронов Д.М. Синдром нарушенной толерантности к атерогенным пищевым жирам: клинико-биохимические проявления, метод выявления. Медицинская технология. 2010. Разрешение ФС № 2010/073 от 16 марта 2010 г.
32. Chin-Dusting J PF, Shaw JA Lipids and atherosclerosis: clinical management of hypercholesterolaemia. Exp Opin Pharmacother 2001; 2: 419–30.
33. Naoumova R, Dunn S, Rallidis L et al. Prolonged inhibition of cholesterol synthesis explains the efficacy of atorvastatin. J Lipid Res 1997; 38: 1496–500.
34. Jones P, Kafonek S, Laurora I et al. Comparative dose efficacy study of atorvastatin versus simvastatin, pravastatin, lovastatin and fluvastatin in patients with hypercholesterolemia (The Curves study). Am J Cardiol 1998; 81: 582–7.
35. Eastaugh JL, Calvert MJ, Freemantle N Highlighting the need for better patient care in stable angina: results of the international Angina Treatment Patterns (ATP) Survey in 7074 patients. Family Practice 2005; 22: 43–50.
36. Бубнова М.Г., Аронов Д.М., Оганов Р.Г., Рудоманов О.Г и др. (от имени исследователей). Клиническая характеристика и общие подходы к лечению пациентов со стабильной стенокардией в реальной практике. Российское исследование ПЕРСПЕКТИВА (ч. I). Кардиоваск. тер. и профилакт. 2010; 6: 47–56.
37. Sever P, Dahlöf B, Poulter N et al. Prevention of coronary and store events with atorvastatin in hypertensive pations who have average or lower-than-average cholesterol concentrations, in the Ango-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOTT-LLA): a multicentre randomized controlled trial. Lancet 2003; 363: 1149–58.
38. Schwartz GG, Olsson AG, Ezekowitz MD et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 2001; 285: 1711–8.
39. Cannon CP et al. Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes. Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis in Myocardial Infarction 22. N Engl J Med 2004; 350: 1495–504.
40. Pitt B, Waters D, Brown WV, van Boven AJ et al. for Atorvastatin versus Revascularization Treatment Investigators. Aggressive lipid-lowing therapy compared with angioplasty in stable coronary artery disease. N Engl J Med 1999; 341: 70–6.
41. Wijns W, Kolh P, Danchin N et al. Guidelines on myocardial revascularization. ESC /EACTS Guidelines. Eur Heart J 2010; 31: 2501–55.
42. Koren NJ Statin use in a «real-world» clinical setting: aggressive lipid lowering compared with usual care in the Aggressive Lipid-Lowering Initiation Abates New Cardiac Events (ALLIANCE) trial. Am J Medicine 2005; 118 (12A): 165–215.
43. LaRosa JC, Grundy SM, Waters DD, Shear C et al. Treating to New Targets (TNT) Investigators. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005; 352 (14): 1425–35.
44. Pedersen TR, Faergeman O, Kastelein JJP et al. High-Dose Atorvastatin vs Usual-Dose Simvastatin for Secondary Prevention After Myocardial Infarction. The IDEAL Study: A Randomized Controlled Trial JAMA 2005; 294: 2437–45.
45. Athyros VG et al. Effect of atorvastatin on high density lipoprotein cholesterol and its relationship with coronary events: a subgroup analysis of the GREek Atorvastatin and Coronary heart- disease Evaluation (GREACE) Study. Curr Med Res Opin 2004; 20 (5) 627–37.
46. Patti G, Pasceri V, Colonna G et al. Atorvastatin Pretreatment Improves Outcomes in patients with acute coronary syndromes undergoing early percutaneous coronary intervention. Results of the ARMYDA-ACS Randomized Trial. J Am Coll Cardiol 2007; 49: 1272–8.
47. Sciascio GD, Patti G, Pasceri V. Efficacy of atorvastatin reload in patients on chronic statin therapy undergoing percutaneous coronary intervention: Results of the ARMYDA-RECAPTURE (Atorvastatin for reduction of myocardial damage during angioplasty) Randomized Trial. J Am Coll Cardiol 2009; 54: 558–65.
48. Amarenco P et al High-Dose Atorvastatin after Stroke or Transient Ischemic Attack. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL). N Eng J Med 2006; 355: 549–59.
Авторы
М.Г.Бубнова
ФГУ ГНИЦ профилактической медицины Минздравсоцразвития РФ, Москва
mbubnova@gnicpm.ru
State Research Center for Preventive Medicine. State Federal Agency for Health and Social Development. Moscow, Russia
mbubnova@gnicpm.ru
ФГУ ГНИЦ профилактической медицины Минздравсоцразвития РФ, Москва
mbubnova@gnicpm.ru
________________________________________________
State Research Center for Preventive Medicine. State Federal Agency for Health and Social Development. Moscow, Russia
mbubnova@gnicpm.ru
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