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Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension

The primary and secondary prevention strategies of atherosclerotic cardiovascular disease (ASCVD) largely rely on the management of arterial hypertension and hypercholesterolemia, two major risk factors possibly linked in pathophysiological terms by the renin-angiotensin system activation and that o...

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Autores principales: Grassi, Guido, Del Pinto, Rita, Agabiti Rosei, Claudia, Agnoletti, Davide, Borghi, Claudio, Cicero, Arrigo F. G., De Ciuceis, Carolina, Desideri, Giovambattista, Grassi, Davide, Muiesan, Maria Lorenza, Paini, Anna, Salvetti, Massimo, Tocci, Giuliano, Veglio, Franco, Volpe, Massimo, Ferri, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8942896/
https://www.ncbi.nlm.nih.gov/pubmed/34978703
http://dx.doi.org/10.1007/s40292-021-00501-6
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author Grassi, Guido
Del Pinto, Rita
Agabiti Rosei, Claudia
Agnoletti, Davide
Borghi, Claudio
Cicero, Arrigo F. G.
De Ciuceis, Carolina
Desideri, Giovambattista
Grassi, Davide
Muiesan, Maria Lorenza
Paini, Anna
Salvetti, Massimo
Tocci, Giuliano
Veglio, Franco
Volpe, Massimo
Ferri, Claudio
author_facet Grassi, Guido
Del Pinto, Rita
Agabiti Rosei, Claudia
Agnoletti, Davide
Borghi, Claudio
Cicero, Arrigo F. G.
De Ciuceis, Carolina
Desideri, Giovambattista
Grassi, Davide
Muiesan, Maria Lorenza
Paini, Anna
Salvetti, Massimo
Tocci, Giuliano
Veglio, Franco
Volpe, Massimo
Ferri, Claudio
author_sort Grassi, Guido
collection PubMed
description The primary and secondary prevention strategies of atherosclerotic cardiovascular disease (ASCVD) largely rely on the management of arterial hypertension and hypercholesterolemia, two major risk factors possibly linked in pathophysiological terms by the renin-angiotensin system activation and that often coexist in the same patient synergistically increasing cardiovascular risk. The classic pharmacologic armamentarium to reduce hypercholesterolemia has been based in the last two decades on statins, ezetimibe, and bile acid sequestrants. More recently numerous novel, additive resources targeting different pathways in LDL cholesterol metabolism have emerged. They include drugs targeting the proprotein convertase subtilisin/kexin type 9 (PCSK9) (inhibitory antibodies; small-interfering RNAs), the angiopoietin-like protein 3 (inhibitory antibodies), and the ATP-citrate lyase (the inhibitory oral prodrug, bempedoic acid), with PCSK9 inhibitors and bempedoic acid already approved for clinical use. With the potential of at least halving LDL cholesterol levels faster and more effectively with the addition of ezetimibe than with high-intensity statin alone, and even more with the addition of the novel available drugs, this document endorsed by the Italian Society of Hypertension proposes a novel paradigm for the treatment of the hypertensive patient with hypercholesterolemia at high and very high ASCVD risk. Our proposal is based on the use as a first-line of a preferably fixed combination of lipid-lowering drugs, under the motto “Our goal: achieve control. No setback: combine and check”.
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spelling pubmed-89428962022-04-07 Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension Grassi, Guido Del Pinto, Rita Agabiti Rosei, Claudia Agnoletti, Davide Borghi, Claudio Cicero, Arrigo F. G. De Ciuceis, Carolina Desideri, Giovambattista Grassi, Davide Muiesan, Maria Lorenza Paini, Anna Salvetti, Massimo Tocci, Giuliano Veglio, Franco Volpe, Massimo Ferri, Claudio High Blood Press Cardiovasc Prev Consensus Document The primary and secondary prevention strategies of atherosclerotic cardiovascular disease (ASCVD) largely rely on the management of arterial hypertension and hypercholesterolemia, two major risk factors possibly linked in pathophysiological terms by the renin-angiotensin system activation and that often coexist in the same patient synergistically increasing cardiovascular risk. The classic pharmacologic armamentarium to reduce hypercholesterolemia has been based in the last two decades on statins, ezetimibe, and bile acid sequestrants. More recently numerous novel, additive resources targeting different pathways in LDL cholesterol metabolism have emerged. They include drugs targeting the proprotein convertase subtilisin/kexin type 9 (PCSK9) (inhibitory antibodies; small-interfering RNAs), the angiopoietin-like protein 3 (inhibitory antibodies), and the ATP-citrate lyase (the inhibitory oral prodrug, bempedoic acid), with PCSK9 inhibitors and bempedoic acid already approved for clinical use. With the potential of at least halving LDL cholesterol levels faster and more effectively with the addition of ezetimibe than with high-intensity statin alone, and even more with the addition of the novel available drugs, this document endorsed by the Italian Society of Hypertension proposes a novel paradigm for the treatment of the hypertensive patient with hypercholesterolemia at high and very high ASCVD risk. Our proposal is based on the use as a first-line of a preferably fixed combination of lipid-lowering drugs, under the motto “Our goal: achieve control. No setback: combine and check”. Springer International Publishing 2022-01-03 2022 /pmc/articles/PMC8942896/ /pubmed/34978703 http://dx.doi.org/10.1007/s40292-021-00501-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Consensus Document
Grassi, Guido
Del Pinto, Rita
Agabiti Rosei, Claudia
Agnoletti, Davide
Borghi, Claudio
Cicero, Arrigo F. G.
De Ciuceis, Carolina
Desideri, Giovambattista
Grassi, Davide
Muiesan, Maria Lorenza
Paini, Anna
Salvetti, Massimo
Tocci, Giuliano
Veglio, Franco
Volpe, Massimo
Ferri, Claudio
Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension
title Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension
title_full Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension
title_fullStr Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension
title_full_unstemmed Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension
title_short Reduction of High Cholesterol Levels by a Preferably Fixed-Combination Strategy as the First Step in the Treatment of Hypertensive Patients with Hypercholesterolemia and High/Very High Cardiovascular Risk: A Consensus Document by the Italian Society of Hypertension
title_sort reduction of high cholesterol levels by a preferably fixed-combination strategy as the first step in the treatment of hypertensive patients with hypercholesterolemia and high/very high cardiovascular risk: a consensus document by the italian society of hypertension
topic Consensus Document
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8942896/
https://www.ncbi.nlm.nih.gov/pubmed/34978703
http://dx.doi.org/10.1007/s40292-021-00501-6
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