Physicians' Academy for Cardiovascular Education

Vascular function as an early sign of trouble

3' education - July 28, 2011

Vascular function as an early sign of trouble:

How can the inhibition of cholesterol absorption reduce the atherogenic load of intestinal lipoproteins? 

Postprandial hyperlipidemia is caused by the increased influx of lipids from the intestine after a meal. Very small remnant particles are left in the circulation. These very small remnant particles can interact with the vessel wall and can even penetrate the vessel wall. Nonfasting triglyceride plasma levels are associated with increased CVD risk; in the postprandial phase HDL-c plasma levels drop.

 

Postprandial lipids (triglyceride-rich lipoprotein or lipoprotein-remnant particles) are associated with endothelial dysfunction, elevated small LDL particles, Factor VII, plasminogen activator inhibitor-1 (PAI-1) and C-reactive protein (CRP).

Postprandial hyperlipidemia can be reduced with lipid-lowering therapy. The PostprAndial eNdothelial function After Combination of Ezetimibe and simvAstatin (PANACEA) Study was designed to evaluate the effect of simvastatin/ezetimibe or high-dose simvastatin alone on fasting and postprandial endothelial function. Statin monotherapy and ezetimibe monotherapy preserve post-fatload endothelial function and also a combination of low-dose statin with ezetimibe preserves post-fatload endothelial function. There is a protective effect of both treatments. Although an appealing pathophysiological concept, the clinical usefulness of postprandial hyperlipidemia remains to be determined.



View the expert opinion interview with Prof. Visseren
 


About the speaker

Frank L.J. Visseren is internist and professor of Vascular Medicine at the Department of Vascular Medicine at the University Medical Center (UMC) Utrecht, The Netherlands.

His clinical work is concentrated around patients at high risk for the development of cardiovascular diseases including patients with familial hypercholesterolemia. His main research interest is in the field of insulin resistance and vascular diseases and consists of translational and epidemiologic research focusing on the role of visceral adipocytes in the development of atherosclerosis and diabetes.

View the presentation slides


 

Vascular function as an early sign of trouble:

How can the inhibition of cholesterol absorption reduce the atherogenic load of intestinal lipoproteins?

Prof. Frank Visseren, MD
Academic Medical Centre Utrecht
The Netherlands
MC Lipid Innovations - May 2011

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