Drugs and lifestyle for the treatment and prevention of coronary artery disease - comparative analysis of the scientific basis

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Arquivos
art_LUZ_Drugs_and_lifestyle_for_the_treatment_and_prevention_2011.PDF (1.25 MB)
Citações na Scopus
16
Tipo de produção
article
Data de publicação
2011
Editora
ASSOC BRAS DIVULG CIENTIFICA
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
NISHIYAMA, M.
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
BRAZILIAN JOURNAL OF MEDICAL AND BIOLOGICAL RESEARCH, v.44, n.10, p.973-991, 2011
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
In this article, we compare two strategies for atherosclerosis treatment: drugs and healthy lifestyle. Statins are the principal drugs used for the treatment of atherosclerosis. Several secondary prevention studies have demonstrated that statins can significantly reduce cardiovascular events including coronary death, the need for surgical revascularization, stroke, total mortality, as well as fatal and non-fatal myocardial infarction. These results were observed in both men and women, the elderly, smokers and non-smokers, diabetics and hypertensives. Primary prevention studies yielded similar results, although total mortality was not affected. Statins also induce atheroma regression and do not cause cancer. However, many unresolved issues remain, such as partial risk reduction, costs, several potential side effects, and long-term use by young patients. Statins act mainly as lipid-lowering drugs but pleiotropic actions are also present. Healthy lifestyle, on the other hand, is effective and inexpensive and has no harmful effects. Five items are associated with lower cardiac risk: non-smoking, BMI <= 25, regular exercise (30 min/day), healthy diet (fruits, vegetables, low-saturated fat, and 5-30 g alcohol/day). Nevertheless, there are difficulties in implementing these measures both at the individual and population levels. Changes in behavior require multidisciplinary care, including medical, nutritional, and psychological counseling. Participation of the entire society is required for such implementation, i.e., universities, schools, media, government, and medical societies. Although these efforts represent a major challenge, such a task must be faced in order to halt the atherosclerosis epidemic that threatens the world.
Palavras-chave
Atherosclerosis, Statins, Lifestyle, Coronary disease, Prevention
URI
https://observatorio.fm.usp.br/handle/OPI/22798
Referências
  1. KANNEL WB, 1961, ANN INTERN MED, V55, P33
  2. Knoops KTB, 2004, JAMA-J AM MED ASSOC, V292, P1433, DOI 10.1001/jama.292.12.1433
  3. Crouse JR, 2007, JAMA-J AM MED ASSOC, V297, P1344, DOI 10.1001/jama.297.12.1344
  4. Puska P, 2009, ANN NUTR METAB, V54, P33, DOI 10.1159/000220825
  5. Baigent C, 2005, LANCET, V366, P1267, DOI 10.1016/S0140-6736(05)67394-1
  6. Sekikawa A, 2008, J AM COLL CARDIOL, V52, P417, DOI 10.1016/j.jacc.2008.03.047
  7. Nissen SE, 2005, NEW ENGL J MED, V352, P29, DOI 10.1056/NEJMoa042000
  8. Fliser D, 2004, CIRCULATION, V110, P1103, DOI 10.1161/01.CIR.0000140265.21608.8E
  9. Hamer M, 2008, J AM COLL CARDIOL, V52, P2156, DOI 10.1016/j.jacc.2008.08.057
  10. Cannon CP, 2004, NEW ENGL J MED, V350, P1495, DOI 10.1056/NEJMoa040583
  11. Vasan RS, 2001, NEW ENGL J MED, V345, P1291, DOI 10.1056/NEJMoa003417
  12. Sacks FM, 2009, NEW ENGL J MED, V360, P859, DOI 10.1056/NEJMoa0804748
  13. Baigent C, 2010, LANCET, V376, P1670, DOI 10.1016/S0140-6736(10)61350-5
  14. Sabate J, 2010, ARCH INTERN MED, V170, P821, DOI 10.1001/archinternmed.2010.79
  15. Cohen HW, 2000, AM J MED, V108, P2, DOI 10.1016/S0002-9343(99)00301-0
  16. Booker CS, 2008, NUTR METAB CARDIOVAS, V18, P448, DOI 10.1016/j.numecd.2008.02.005
  17. Ridker PM, 2008, NEW ENGL J MED, V359, P2195, DOI 10.1056/NEJMoa0807646
  18. Parikh P, 2005, J AM COLL CARDIOL, V45, P1379, DOI 10.1016/j.jacc.2004.11.068
  19. Manson JE, 2002, NEW ENGL J MED, V347, P716, DOI 10.1056/NEJMoa021067
  20. BANG HO, 1971, LANCET, V1, P1143
  21. MARMOT MG, 1991, LANCET, V337, P1387
  22. Werner C, 2008, J AM COLL CARDIOL, V52, P470, DOI 10.1016/j.jacc.2008.04.034
  23. Bibbins-Domingo K, 2010, NEW ENGL J MED, V362, P590, DOI 10.1056/NEJMoa0907355
  24. Mukamal KJ, 2010, J AM COLL CARDIOL, V55, P1328, DOI 10.1016/j.jacc.2009.10.056
  25. Tuomilehto J, 2001, LANCET, V357, P848, DOI 10.1016/S0140-6736(00)04199-4
  26. Tang TY, 2009, J AM COLL CARDIOL, V53, P2039, DOI 10.1016/j.jacc.2009.03.018
  27. Nissen SE, 2006, JAMA-J AM MED ASSOC, V295, P1556, DOI 10.1001/jama.295.13.jpc60002
  28. Rosengren A, 2004, LANCET, V364, P953, DOI 10.1016/S0140-6736(04)17019-0
  29. Ford I, 2007, NEW ENGL J MED, V357, P1477, DOI 10.1056/NEJMoa065994
  30. Lopez-Garcia E, 2005, J NUTR, V135, P562
  31. Howitz KT, 2003, NATURE, V425, P191, DOI 10.1038/nature01960
  32. Benjo AM, 2006, ATHEROSCLEROSIS, V187, P116, DOI 10.1016/j.athersclerosis.2005.08.025
  33. Rozanski A, 2005, J AM COLL CARDIOL, V45, P637, DOI 10.1016/j.jac.2004.12.005
  34. Trichopoulou A, 2003, NEW ENGL J MED, V348, P2599, DOI 10.1056/NEJMoa025039
  35. Baur JA, 2006, NATURE, V444, P337, DOI 10.1038/nature05354
  36. Chandola T, 2008, EUR HEART J, V29, P640, DOI 10.1093/eurheartj/ehm584
  37. Yusuf S, 2000, NEW ENGL J MED, V342, P145
  38. Chiuve SE, 2008, CIRCULATION, V118, P947, DOI 10.1161/CIRCULATIONAHA.108.781062
  39. Ford ES, 2007, NEW ENGL J MED, V356, P2388, DOI 10.1056/NEJMsa053935
  40. Ornish D, 1998, JAMA-J AM MED ASSOC, V280, P2001, DOI 10.1001/jama.280.23.2001
  41. Nissen SE, 2003, JAMA-J AM MED ASSOC, V290, P2292, DOI 10.1001/jama.290.17.2292
  42. Linden W, 1996, ARCH INTERN MED, V156, P745, DOI 10.1001/archinte.156.7.745
  43. Redberg RF, 2009, CIRCULATION, V120, P1296, DOI 10.1161/CIRCULATIONAHA.109.192617
  44. KROMANN N, 1980, ACTA MED SCAND, V208, P401
  45. O'Keefe JH, 2008, J AM COLL CARDIOL, V51, P249, DOI 10.1016/j.jacc.2007.10.016
  46. de Lorgeril M, 1999, CIRCULATION, V99, P779
  47. Iestra JA, 2005, CIRCULATION, V112, P924, DOI 10.1161/CIRCULATIONAHA.104.503995
  48. Briel M, 2009, BRIT MED J, V338, DOI 10.1136/bmj.b92
  49. Casella A, 2011, AM J CARDIOL, V107, P1168, DOI 10.1016/j.amjcard.2010.12.014
  50. Chiuve SE, 2006, CIRCULATION, V114, P160, DOI 10.1161/CIRCULATIONAHA.106.621417
  51. Clarke R, 2009, BRIT MED J, V339, DOI 10.1136/bmj.b3513
  52. da Luz P L, 1995, Arq Bras Cardiol, V64, P1
  53. da Luz Protásio Lemos, 2005, Clinics (Sao Paulo), V60, P415, DOI 10.1590/S1807-59322005000500011
  54. da Luz PL, 2004, BRAZ J MED BIOL RES, V37, P1275, DOI 10.1590/S0100-879X2004000900001
  55. Forrester JS, 2010, J AM COLL CARDIOL, V56, P630, DOI 10.1016/j.jacc.2009.11.090
  56. Fraser GE, 2001, ARCH INTERN MED, V161, P1645, DOI 10.1001/archinte.161.13.1645
  57. FRIEDMAN M, 2000, DEZ MAIORES DESCOBER
  58. Harris W, 2008, J AM COLL CARDIOL, V52, P425, DOI 10.1016/j.jacc.2008.04.018
  59. JAMISON DT, 2006, PRIORITIES HLTH WORL, P97, DOI 10.1596/978-0-8213-6260-0/Chpt-5
  60. JOOSSENS JV, 1991, AM J MED, V90, pS5, DOI 10.1016/0002-9343(91)90428-Z
  61. Keys A, 1966, Acta Med Scand Suppl, V460, P1
  62. Bray GA, 2009, LANCET, V374, P1677, DOI 10.1016/S0140-6736(09)61457-4
  63. PERRY IJ, 1992, J HUM HYPERTENS, V6, P23
  64. Peto R, 2010, NEW ENGL J MED, V362, P855, DOI 10.1056/NEJMc1000079
  65. Ronksley PE, 2011, BRIT MED J, V342, DOI 10.1136/bmj.d671
  66. Rubins HB, 1996, AM J CARDIOL, V78, P572, DOI 10.1016/S0002-9149(96)00369-4
  67. *SUS MIN SAUD BRAS, MORT DOENC CARD CAEM
  68. Trichopoulou A, 2009, BRIT MED J, V338, DOI 10.1136/bmj.b2337
  69. Werle MH, 2011, EUR J CARDIOVASC PRE

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor