This continuing feature will update readers on recent developments in cardiovascular pharmacotherapy. Cardiovascular disease remains the number one killer in the US, and more clinical outcome trials have been conducted in cardiology than in any other field of medicine. Given this rapidly expanding knowledge base, pharmacists can have a significant impact on prevention and treatment — if they keep current with developments in drug therapy.
Get full access to this article
View all access options for this article.
References
1.
National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation.2002; 106(25): 3143–3421.
2.
Association Heart Association.Heart Disease and Stroke Statistics-2005 Update.Dallas, TX: Association Heart Association; 2005.
3.
Heart Protection Study Collaborative Group.MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomized placebo-controlled trial. Lancet.2002; 360(9326): 7–22.
4.
CannonC.P., BraunwaldE., McCabeC.H.Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med.2004; 350(15): 1495–1504.
5.
SeverP.S., DahlofB., PoulterN.R.Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA): a multicentre randomized controlled trial. Lancet.2003; 361(9364): 1149–1158.
6.
ShepherdJ., BlauwG.J., MurphyM.B.Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomized controlled trial. Lancet.2002; 360(9346): 1623–1630.
7.
ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group.The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT). JAMA.2002; 288(23): 2998–3007.
8.
GrundyS.M., CleemanJ.I., MerzC.N.Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation.2004; 110(2): 227–239.
9.
ChobanianA.V., BakrisG.L., BlackH.R.The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA.2003; 289(19): 2560–2572.
10.
American Diabetes Association.Clinical Practice Recommendations 2005. Diabetes Care.2005; 28(1): S3.
11.
PasternakR.C., SmithS.C.Jr., Bairey-MerzCN, . ACC/AHA/NHLBI clinical advisory on the use and safety of statins. Circulation.2002; 106(8): 1024–1028.
12.
O'KeefeJ.H.Jr, CordainL., HarrisW.H., MoeR.M., VogelR.Optimal low-density lipoprotein is 50 to 70 mg/dL: lower is better and physiologically normal. J Am Coll Cardiol.2004; 43(11): 2142–2146.
13.
NissenS.E., TuzcuE.M., SchoenhagenP.Effect of Intensive Compared With Moderate Lipid-Lowering Therapy on Progression of Coronary Atherosclerosis. JAMA.2004; 291: 1071–1080.
14.
TaylorA.J., KentS.M., FlahertyP.J.ARBITER: arterial biology for the investigation of the treatment effects of reducing cholesterol. Circulation.2002; 106: 2055–2060.
15.
PearsonT.A., LauroraI., ChuH., KafonekS.The lipid treatment assessment project (L-TAP): a multicenter survey to evaluate the percentages of dyslipidemic patients receiving lipid-lowering therapy and achieving low-density lipoprotein cholesterol goals. Arch Intern Med.2000; 160(4): 459–467.
16.
WorzC.R., BottorffM.Treating dyslipidemic patients with lipid-modifying and combination therapies. Pharmacotherapy.2003; 23(5): 625–637.
17.
BallantyneC.M., HouriJ., NotarbartoloA.Effect of ezetimibe coadministered with atorvastatin in 628 patients with primary hypercholesterolemia: a prospective, randomized, double-blind trial. Circulation.2003; 107(19): 2409–2415.
18.
BallantyneC.M., AbateN., YuanZ., KingT.R., PalmisanoJ.Dose-comparison study of the combination of ezetimibe and simvastatin (Vytorin) versus atorvastatin in patients with hypercholesterolemia: the Vytorin Versus Atorvastatin (VYVA) study. Am Heart J.2005; 149(3): 464–473.
19.
GuytonJ.R., GoldbergA.C., KreisbergR.A., SprecherD.L., SuperkoH.R., O'ConnorC.M.Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol.1998; 82(6): 737–743.
20.
BrownB.G., ZhaoX.Q., ChaitA.Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med.2001; 345(22): 1583–1592.
21.
KashyapM.L., McGovernM.E., BerraK.Long-term safety and efficacy of a once-daily niacin/lovastatin formulation for patients with dyslipidemia. Am J Cardiol.2002; 89(6): 672–678.
22.
AthyrosV.G., PapageorgiouA.A., AthyrouV.V., DemitriadisD.S., KontopoulosA.G.Atorvastatin and micronized fenofibrate alone and in combination in type 2 diabetes with combined hyperlipidemia. Diabetes Care.2002; 25(7): 1198–1202.
23.
AthyrosV.G., PapageorgiouA.A., HatzikonstandinouH.A.Safety and efficacy of long-term statin-fibrate combinations in patients with refractory familial combined hyperlipidemia. Am J Cardiol.1997; 80(5): 608–613.
24.
DerosaG., CiceroA.E., BertoneG., PiccinniM.N., CiccarelliL., RoggeriD.E.Comparison of fluvastatin + fenofibrate combination therapy and fluvastatin monotherapy in the treatment of combined hyperlipidemia, type 2 diabetes mellitus, and coronary heart disease: a 12-month, randomized, double-blind, controlled trial. Clin Ther.2004; 26(10): 1599–1607.
25.
LiamisG., KakafikaA., BairaktariE.Combined treatment with fibrates and small doses of atorvastatin in patients with mixed hyperlipidemia. Curr Med Res Opin.2002; 18(3): 125–128.
26.
GawA., PackardC.J., LindsayG.M.Effects of colestipol alone and in combination with simvastatin on apolipoprotein B metabolism. Arterioscler Thromb Vasc Biol.1996; 16(2): 236–249.
27.
KnappH.H., SchrottH., MaP.Efficacy and safety of combination simvastatin and colesevelam in patients with primary hypercholesterolemia. Am J Med.2001; 110(5): 352–360.
28.
JonesP.H., DavidsonM.H., SteinE.A.Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR* Trial). Am J Cardiol.2003; 92(2): 152–160.
29.
DavidsonM.H.Combination therapy for dyslipidemia: safety and regulatory considerations. Am J Cardiol.2002; 90(10B): 50K–60K.
30.
WolfeM.L., VartanianS.F., RossJ.L.Safety and effectiveness of Niaspan when added sequentially to a statin for treatment of dyslipidemia. Am J Cardiol.2001; 87(4): 476–479, A7.
31.
McKenneyJ.Combination therapy for elevated low-density lipoprotein cholesterol: the key to coronary artery disease risk reduction. Am J Cardiol.2002; 90(10B): 8K–20K.
32.
StaffaJ.A., ChangJ., GreenL.Cerivastatin and reports of fatal rhabdomyolysis. N Engl J Med.2002; 346(7): 539–540.
33.
JonesP.H., DavidsonM.H.Reporting rate of rhabdomyolysis with fenofibrate + statin versus gemfibrozil + any statin. Am J Cardiol.2005; 95: 120–122.
34.
GrahamD.J., StaffaJ.A., ShatinD.Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs. JAMA.2004; 292(21): 2585–2590.
35.
McKenneyJ.M., ProctorJ.D., HarrisS., ChinchiliV.M.A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA.1994; 271(9): 672–677.
36.
ShekA., FerrillM.J.Statin-fibrate combination therapy. Ann Pharmacother.2001; 35(7-8): 908–917.
37.
McKenneyJ.New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med.2004; 164(7): 697–705.
38.
GlueckC.J., KelleyW., GuptaA., FontaineR.N., WangP., GartsideP.S.Prospective 10-year evaluation of hypobetalipoproteinemia in a cohort of 772 firefighters and cross-sectional evaluation of hypocholesterolemia in 1,479 men in the National Health and Nutrition Examination Survey I. Metabolism.1997; 46(6): 625–633.