Monday, September 1, 2014

Triglycerides and cardiovascular disease

I suppose I shouldn't comment on doctors  area of expertise, but I still think that they need to solve why inflammation occurs rather than the particles floating in the bloodstream. Have they never heard of cause and effect or root cause analysis. They wouldn't last a week in a programming environment. They would be fired within days for suggesting working on peripheral issues rather than solving the real problem.  But then this is somebody else's problem, no need to really worry about it. I'll get paid regardless.  Pay for performance would solve that problem or having business rules apply to doctors.
http://www.mdlinx.com/internal-medicine/newsl-article.cfm/5485946/ZZF307965849E94474BB34FC062CEC0F93/?
Nordestgaard BG, et al. – After the introduction of statins, clinical emphasis first focussed on LDL cholesterol–lowering, then on the potential for raising HDL cholesterol, with less focus on lowering triglycerides.
  • However, the understanding from genetic studies and negative results from randomised trials that low HDL cholesterol might not cause cardiovascular disease as originally thought has now generated renewed interest in raised concentrations of triglycerides.
  • This renewed interest has also been driven by epidemiological and genetic evidence supporting raised triglycerides, remnant cholesterol, or triglyceride–rich lipoproteins as an additional cause of cardiovascular disease and all–cause mortality.
  • Triglycerides can be measured in the non–fasting or fasting states, with concentrations of 2—10 mmol/L conferring increased risk of cardiovascular disease, and concentrations greater than 10 mmol/L conferring increased risk of acute pancreatitis and possibly cardiovascular disease.
  • Although randomised trials showing cardiovascular benefit of triglyceride reduction are scarce, new triglyceride–lowering drugs are being developed, and large–scale trials have been initiated that will hopefully provide conclusive evidence as to whether lowering triglycerides reduces the risk of cardiovascular disease.

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