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The 2003 Canadian recommendations for dyslipidemia management: revisions are needed.

https://arctichealth.org/en/permalink/ahliterature175311
Source
CMAJ. 2005 Apr 12;172(8):1027-31
Publication Type
Article
Date
Apr-12-2005
Author
Douglas G Manuel
Peter Tanuseputro
Cameron A Mustard
Susan E Schultz
Geoffrey M Anderson
Sten Ardal
David A Alter
Andreas Laupacis
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Ont. doug.manuel@ices.on.ca
Source
CMAJ. 2005 Apr 12;172(8):1027-31
Date
Apr-12-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Cholesterol, LDL - blood
Coronary Disease - mortality - prevention & control
Cost-Benefit Analysis
Health Expenditures
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipidemias - drug therapy
Hypolipidemic Agents - therapeutic use
Middle Aged
Practice Guidelines as Topic
Risk factors
Notes
Cites: Eur Heart J. 2003 Sep;24(17):1601-1012964575
Cites: CMAJ. 2003 Jun 24;168(13):1644-5; author reply 1645-612821610
Cites: Can J Cardiol. 2003 Nov;19(12):1359-6614631469
Cites: Can J Cardiol. 2003 Dec;19(13):1499-50214760440
Cites: Am J Med. 2004 Apr 15;116(8):540-515063816
Cites: JAMA. 2004 Apr 21;291(15):1864-7015100205
Cites: Am Heart J. 1991 Jan;121(1 Pt 2):293-81985385
Cites: N Engl J Med. 1998 Nov 5;339(19):1349-579841303
Cites: Can J Cardiol. 1999 Apr;15(4):445-5110322254
Cites: CMAJ. 2003 Oct 28;169(9):921-414581310
Cites: Fam Pract. 2003 Feb;20(1):16-2112509365
Cites: JAMA. 2002 Jul 24-31;288(4):462-712132976
Cites: JAMA. 2002 Jul 24-31;288(4):455-6112132975
Cites: JAMA. 1999 Dec 22-29;282(24):2340-610612322
Cites: CMAJ. 2000 May 16;162(10):1441-710834048
Cites: CMAJ. 2000 Aug 22;163(4):403-810976255
Cites: Lancet. 2002 Jul 6;360(9326):7-2212114036
Comment In: CMAJ. 2005 Nov 8;173(10):1210; author reply 121016275979
Comment In: CMAJ. 2005 Nov 8;173(10):1207; author reply 121016275976
Comment In: CMAJ. 2005 Apr 12;172(8):1033-4; discussion 103715824410
Erratum In: CMAJ. 2005 Jul 19;173(2):133
PubMed ID
15824409 View in PubMed
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Adherence to lipid-lowering drug therapy among members of the Canadian Forces.

https://arctichealth.org/en/permalink/ahliterature155689
Source
Mil Med. 2008 Jul;173(7):666-70
Publication Type
Article
Date
Jul-2008
Author
Janice Ma
Régis Vaillancourt
Carol Bennett
Author Affiliation
Directorate of Medical Policy, Pharmacy Policies and Standards, National Defence Medical Centre Building, 2nd Floor, 1745 Alta Vista Drive, Ottawa, Ontario, K1A 0K6, Canada.
Source
Mil Med. 2008 Jul;173(7):666-70
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Adult
Canada
Databases as Topic
Female
Humans
Hyperlipidemias - drug therapy
Hypolipidemic Agents - therapeutic use
Logistic Models
Male
Middle Aged
Military Medicine
Military Personnel - statistics & numerical data
Ontario
Patient Compliance - statistics & numerical data
Prospective Studies
Risk factors
Abstract
This study was performed to quantify adherence rates to lipid-lowering drug therapy among members of the Canadian Forces (CF) and to identify factors associated with nonadherence.
Pharmacy claims were reviewed for all CF members who received a lipid-lowering drug between April 1 and June 1, 2003. Subjects were categorized as adherent if records indicated consumption of at least 80% of prescribed doses. Logistic regression was performed to assess the impact of patient and drug characteristics upon adherence.
Overall adherence rate at 1 year was 38.5% among all users of lipid-lowering medications. Adherence did not vary among the different classes of lipid-lowering drugs. Duration of service was the only independent predictor of adherence.
Despite a relative lack of treatment barriers and the presence of established treatment programs in the CF health care system, long-term adherence with lipid-lowering medications remains suboptimal in this population.
Notes
Comment In: Mil Med. 2008 Jul;173(7):iii18700588
PubMed ID
18700601 View in PubMed
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The analysis by Manuel and colleagues creates controversy with headlines, not data.

https://arctichealth.org/en/permalink/ahliterature175310
Source
CMAJ. 2005 Apr 12;172(8):1033-4; discussion 1037
Publication Type
Article
Date
Apr-12-2005
Author
Jacques Genest
Ruth McPherson
Jiri Frohlich
George Fodor
Author Affiliation
Division of Cardiology, Royal Victoria Hospital, McGill University, Montréal, Que. jacques.genest@muhc.mcgill.ca
Source
CMAJ. 2005 Apr 12;172(8):1033-4; discussion 1037
Date
Apr-12-2005
Language
English
Publication Type
Article
Keywords
Canada
Cholesterol, LDL - blood
Coronary Disease - mortality - prevention & control
Health Expenditures
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipidemias - drug therapy
Hypolipidemic Agents - therapeutic use
Practice Guidelines as Topic
Risk factors
Notes
Cites: Circulation. 2003 Apr 22;107(15):2059-6512707251
Cites: JAMA. 1999 Dec 22-29;282(24):2340-610612322
Cites: JAMA. 2001 May 16;285(19):2486-9711368702
Cites: Circulation. 2001 Nov 27;104(22):2746-5311723030
Cites: Circulation. 2001 Dec 4;104(23):2855-6411733407
Cites: Lancet. 2002 Jul 6;360(9326):7-2212114036
Cites: CMAJ. 2005 Apr 12;172(8):1027-3115824409
Cites: CMAJ. 2003 Oct 28;169(9):921-414581310
Cites: Can J Public Health. 2004 Jan-Feb;95(1):16-2014768735
Cites: Circulation. 2004 Jul 13;110(2):227-3915249516
Cites: Lancet. 2004 Sep 11-17;364(9438):937-5215364185
Cites: BMJ. 1992 Jul 4;305(6844):15-91638188
Comment On: CMAJ. 2005 Apr 12;172(8):1027-3115824409
PubMed ID
15824410 View in PubMed
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[Antioxidant and anti-inflammatory effect of "vitalong" in hyperlipidemia in rats]

https://arctichealth.org/en/permalink/ahliterature74952
Source
Ukr Biokhim Zh. 2002 Jan-Feb;74(1):121-4
Publication Type
Article
Author
A P Levitskii
O A Makarenko
E M Novosad
P I Pustovoit
O M Semaniv
Author Affiliation
Odessa State Medical University, Ukraine.
Source
Ukr Biokhim Zh. 2002 Jan-Feb;74(1):121-4
Language
Russian
Publication Type
Article
Keywords
Animals
Anti-Inflammatory Agents - pharmacology - therapeutic use
Antioxidants - pharmacology - therapeutic use
English Abstract
Enzyme Activation
Free Radical Scavengers - pharmacology - therapeutic use
Hyperlipidemia - drug therapy
Male
Pancreatic Elastase - blood
Rats
Abstract
In experiment on model of the lipidemia in rats the efficiency of new antioxidant drug "Vitalong" was studied. The researches have shown that the drug brakes derivation of free radicals, increases activity of a superoxide scavenger, has antiinflammatory and adaptogenic operation. Vitalong prevents activation of serumal elastasa, locking thus destructive link of the atherogenesis. Ukrainian Ministry of Health permits the drug as a preventive means.
PubMed ID
12199092 View in PubMed
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Association Between Use of Lipid-Lowering Therapy and Cardiovascular Diseases and Death in Individuals With Type 1 Diabetes.

https://arctichealth.org/en/permalink/ahliterature286766
Source
Diabetes Care. 2016 Jun;39(6):996-1003
Publication Type
Article
Date
Jun-2016
Author
Christel Hero
Araz Rawshani
Ann-Marie Svensson
Stefan Franzén
Björn Eliasson
Katarina Eeg-Olofsson
Soffia Gudbjörnsdottir
Source
Diabetes Care. 2016 Jun;39(6):996-1003
Date
Jun-2016
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - epidemiology - mortality
Case-Control Studies
Cause of Death
Coronary Disease - epidemiology - mortality
Diabetes Mellitus, Type 1 - epidemiology
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipidemias - drug therapy - epidemiology
Male
Middle Aged
Myocardial Infarction - epidemiology - mortality
Propensity Score
Proportional Hazards Models
Registries
Risk factors
Stroke - epidemiology - mortality
Sweden - epidemiology
Young Adult
Abstract
To evaluate the effect of lipid-lowering therapy (LLT) in primary prevention on cardiovascular disease (CVD) and death in type 1 diabetes.
We used the Swedish National Diabetes Register (NDR) to perform a propensity score-based study. Propensity scores for treatment with LLT were calculated from 32 baseline clinical and socioeconomic variables. The propensity score was used to estimate the effect of LLT in the overall cohort (by stratification). We estimated risk of acute myocardial infarction, stroke, coronary heart disease, and cardiovascular and all-cause mortality in individuals with and without LLT using Cox regression. A total of 24,230 individuals included in 2006-2008 NDR with type 1 diabetes without a history of CVD were followed until 31 December 2012; 18,843 were untreated and 5,387 treated with LLT (97% statins). The mean follow-up was 6.0 years.
The propensity score allowed balancing of all 32 covariates, with no differences between treated and untreated after accounting for propensity score. Hazard ratios (HRs) for treated versus untreated were as follows: cardiovascular death 0.60 (95% CI 0.50-0.72), all-cause death 0.56 (0.48-0.64), fatal/nonfatal stroke 0.56 (0.46-0.70), fatal/nonfatal acute myocardial infarction 0.78 (0.66-0.92), fatal/nonfatal coronary heart disease 0.85 (0.74-0.97), and fatal/nonfatal CVD 0.77 (0.69-0.87).
This observational study shows that LLT is associated with 22-44% reduction in the risk of CVD and cardiovascular death among individuals with type 1 diabetes without history of CVD and underlines the importance of primary prevention with LLT to reduce cardiovascular risk in type 1 diabetes.
PubMed ID
27208327 View in PubMed
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[Can we afford good cholesterol lowering therapy? Budgeting of statin costs versus medical needs in the county of Stockholm]

https://arctichealth.org/en/permalink/ahliterature47626
Source
Lakartidningen. 2001 Nov 28;98(48):5472-3, 5476-8, 5481-3
Publication Type
Article
Date
Nov-28-2001
Author
B. Wettermark
P. Hjemdahl
Author Affiliation
Huddinge Universitetssjukhus, Stockholms läns landsting, ledamot av LAKSAKs expertgrupp för hjärt-kärlsjukdomar i Stockholms läns landsting.
Source
Lakartidningen. 2001 Nov 28;98(48):5472-3, 5476-8, 5481-3
Date
Nov-28-2001
Language
Swedish
Publication Type
Article
Keywords
Adult
Aged
Anticholesteremic Agents - administration & dosage - economics
Budgets
Coronary Disease - drug therapy - prevention & control
Diabetes Mellitus, Type 2 - drug therapy - prevention & control
Drug Costs
English Abstract
Health Priorities - economics
Health Services Needs and Demand - economics
Humans
Hyperlipidemia - drug therapy - prevention & control
Middle Aged
Practice Guidelines
Primary Prevention - economics
Risk factors
Sweden
Abstract
Increasing drug costs are a concern in Sweden. The costs for statin treatment are considerable, and among those increasing most rapidly (by 30-35% per year). Our survey of eligibility for statin treatment in Stockholm according to current Swedish recommendations (i.e. patients 100 M extra for patients > 75 years and/or high cardiovascular risk. We propose that individual risk assessments should replace crude patient group recommendations to obtain reasonable "numbers needed to treat", i.e. to optimize the expenditure on statins and cost-effectiveness of the therapy. Prioritization of drug expenditures (within and between patient categories) must be debated, and medical needs must be made clear to those who determine the medical budget.
PubMed ID
11769362 View in PubMed
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Clinical consequences following regulatory changes in respect to reimbursement of statins cost by the Icelandic Social Insurance Administration.

https://arctichealth.org/en/permalink/ahliterature120236
Source
Scand J Public Health. 2012 Nov;40(7):663-7
Publication Type
Article
Date
Nov-2012
Author
Sveinbjörn Gizurarson
Linda Rós Björnsdóttir
Rannveig Einarsdóttir
Matthías Halldórsson
Karl Andersen
Author Affiliation
Faculty of Pharmaceutical Sciences, School of Health Science, University of Iceland, Hofsvallagata 53, Reykjavik, Iceland. sveinbj@hi.is
Source
Scand J Public Health. 2012 Nov;40(7):663-7
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anticholesteremic Agents - economics - therapeutic use
Cholesterol - blood
Female
Fluorobenzenes - economics - therapeutic use
Follow-Up Studies
Heptanoic Acids - economics - therapeutic use
Humans
Hyperlipidemias - drug therapy
Iceland
Male
Middle Aged
Pravastatin - economics - therapeutic use
Pyrimidines - economics - therapeutic use
Pyrroles - economics - therapeutic use
Reimbursement Mechanisms - legislation & jurisprudence
Simvastatin - economics - therapeutic use
Social Security - organization & administration
Sulfonamides - economics - therapeutic use
Treatment Outcome
Abstract
On 1 March 2009, a new reimbursement system was introduced by the Ministry of Health of Iceland regarding drugs to treat hyperlipidaemia. The Social Insurance Administration was only authorised to reimburse 10 and 20 mg simvastatin unless patients were eligible to receive a medical card from the Social Insurance Administration. The purpose of this study was to evaluate the influence of this reimbursement regulation on the clinical outcome.
Patients that received hyperlipidaemia treatment and were admitted to the cardiac ward were enrolled. The criteria were that the patients had been admitted 1 year prior to the regulation change and were using other statins than simvastatin.
Out of 233 eligible patients 170 (73%) reached the treatment goal before the switch. After the switch, only 126 (54%) reached their goal (p
PubMed ID
23027893 View in PubMed
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[Comparative study of alpha-lipoic acid and mexidol effects on affective status, cognitive functions and quality of life in diabetes mellitus patients].

https://arctichealth.org/en/permalink/ahliterature127505
Source
Eksp Klin Farmakol. 2011;74(11):17-23
Publication Type
Article
Date
2011
Author
I A Volchegorskii
L M Rassokhina
M I Koliadich
M I Alekseev
Source
Eksp Klin Farmakol. 2011;74(11):17-23
Date
2011
Language
Russian
Publication Type
Article
Keywords
Antioxidants - administration & dosage - therapeutic use
Attention - drug effects
Cognition - drug effects
Cognition Disorders - drug therapy - metabolism - physiopathology
Diabetes Complications - drug therapy
Diabetes Mellitus - drug therapy - metabolism - physiopathology
Double-Blind Method
Female
Humans
Hyperglycemia - drug therapy
Hyperlipidemias - drug therapy - metabolism
Hypoglycemic Agents - administration & dosage - therapeutic use
Lipid Peroxidation - drug effects
Male
Middle Aged
Picolines - administration & dosage - therapeutic use
Placebos
Prospective Studies
Psychotropic Drugs - administration & dosage - therapeutic use
Quality of Life
Questionnaires
Russia
Thioctic Acid - administration & dosage - therapeutic use
Abstract
Short-term, prospective placebo-controlled simple blind randomized study of the effects of alpha-lipoic acid and mexidol on the dynamics of affective status disorders, cognitive functions, and quality of life in parallel with changes in carbohydrate metabolism and lipidemia has been conducted in diabetic patients. It is established that two-week administration of alpha-lipoic acid (600 mg once a day, i.v.) and mexidol (300 mg once a day, i.v.) reduced hyperglycemia by 13.00 with simultaneous decrease of depressive "feelings of guilt". In case of mexidol, these effects were accompanied by positive "vitality" dynamics established with SF-36 questionnaire and reflecting improvement in patients' quality of life. Additionally, course administration of alpha-lipoic acid increased attention as studied with Schulte tables. Favorable psychotropic effects of alpha-lipoic acid and mexidol were unrelated to changes in lipidemia and "lipid peroxidation - antioxidant protection" system indicators.
PubMed ID
22288155 View in PubMed
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Cost-benefit analysis of lipid lowering therapy.

https://arctichealth.org/en/permalink/ahliterature211592
Source
Eur Heart J. 1996 Jul;17(7):974-5
Publication Type
Article
Date
Jul-1996
Author
A P Davie
J J McMurray
Source
Eur Heart J. 1996 Jul;17(7):974-5
Date
Jul-1996
Language
English
Publication Type
Article
Keywords
Clinical Trials as Topic
Cost-Benefit Analysis
Humans
Hyperlipidemias - drug therapy - economics
Hypolipidemic Agents - economics - therapeutic use
Lovastatin - analogs & derivatives - economics - therapeutic use
Simvastatin
Sweden
Notes
Comment In: Eur Heart J. 1997 Jan;18(1):165-69049529
Comment On: Eur Heart J. 1996 Jul;17(7):1001-78809516
PubMed ID
8809507 View in PubMed
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Cost-effectiveness of single agent, uptitration and switching statin treatment strategies for lipid lowering in Sweden.

https://arctichealth.org/en/permalink/ahliterature146775
Source
Curr Med Res Opin. 2010 Feb;26(2):389-96
Publication Type
Article
Date
Feb-2010
Author
Janne A Martikainen
Erkki Soini
Thomas Paulsson
Author Affiliation
ESiOR Oy, P.O. Box 1188, 70211 Kuopio, Finland. janne.martikainen@esior.fi
Source
Curr Med Res Opin. 2010 Feb;26(2):389-96
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Algorithms
Cardiovascular Diseases - economics - prevention & control
Computer simulation
Cost-Benefit Analysis
Dose-Response Relationship, Drug
Health Planning Guidelines
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage - economics
Hyperlipidemias - drug therapy - economics
Hypolipidemic Agents - administration & dosage - economics
Models, Econometric
Retrospective Studies
Sweden
Treatment Outcome
Withholding Treatment
Abstract
To assess which alternative treatment strategies are optimum in terms of cost-effectiveness (EUR/patient treated to target, EUR/PTT) in lowering cholesterol in high-risk patients with elevated LDL-cholesterol (LDL-C) in Sweden.
A probabilistic cost-effectiveness model was developed to estimate the mean expected costs and proportion of patients reaching goal attainment (defined as LDL-C Simva20 --> Simva40, Rosu10, Simva20 --> Rosu10 --> Rosu20 --> Rosu40, or Simva20 --> Simva40 --> Rosu20 --> Rosu40). An important finding was that when LDL-C level exceed 4.0 mmol/L (154mg/dL) and when willingness to pay is less than 500 EUR per additional PTT, the optimal treatment strategy would be to initiate cholesterol-lowering treatment directly with rosuvastatin 10 mg.
The results of this study indicate that the optimal approach to initiate lipid-lowering therapy would be to treat patients with the lower baseline LDL-C levels with the least costly treatment strategies, while initiating lipid-lowering treatment with a high-potency statin (rosuvastatin) in patients with moderately high or high baseline LDL-C levels. This recommendation can be assumed to be relevant particularly when the fact that after treatment initiation the majority of Swedish patients will not have any changes in their lipid-lowering medication or dose is taken into account. Finally, since only the short-term results are presented here, it would be valuable to conduct further studies of the long-term cost-effectiveness of different statin treatment strategies that focus on treatment persistence and LDL-C goal attainment in real practice.
PubMed ID
20001451 View in PubMed
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30 records – page 1 of 3.