降低血脂 減少心血管病風險Lipid lowering to reduce the risk of cardiovascular disease

降低血脂 減少心血管病風險 【劉惠敏】美國心臟協會年會（AHA）於美國紐奧良舉行，歷時5年的「木星（JUPITER）」研究日前正式發表，針對膽固醇正常，但高敏感C反應蛋白（hs-CRP）持續過高的50歲以上男性、60歲以上女性，若給予司達汀類（Statin）降血脂藥，可以有效減低心血管疾病風險。 「木星（JUPITER）」由美國布里根婦女醫院心臟學者瑞德克（ Ridker）主持，從2003年起至今年3月，研究結果已發表於新英格蘭醫學期刊，是一項橫跨26國，研究對象達17802人的雙盲臨床試驗。 CRP以2為正常數值，研究針對男性50歲以上、女性60歲以上，膽固醇數值正常，但CRP值達4.2者，持續使用降血脂藥Rosuvastatin，每天20毫克，對比服用安慰劑組，可降低低密度膽固醇（LDL，俗稱壞膽固醇）數值，並減少心臟病、中風、心血管疾病致死風險達47%，總死亡率更減少20%。 美國每年有一百萬人死於心血管疾病，醫界過去證實LDL低1%，引發動脈粥狀硬化、阻塞，導致心血管疾病的風險亦降低1%。 瑞德克等學者發現，減少心血管疾病風險，除降低膽固醇，也須減少與發炎有關的CRP濃度，近年研究發現膽固醇在正常範圍，但CRP偏高者亦可能引發心血管疾病，CRP最高族群相較最低族群，罹患心血管疾病危險性高出2到4倍。 AHA主席葛登（Gardner）表示，AHA已於2003年將CRP列為血管發炎、心血管疾病相關指標。，而「木星」研究顯示司達汀藥物同時減低壞膽固醇以及CRP，此研究也再次肯定這一點。參與AHA年會的馬偕醫院心臟科主任侯嘉殷表示，「木星」證實CRP將從「參考指標」成為心血管疾病的危險因子之一，與抽菸、高血壓、膽固醇同為初級預防必須嚴格控管的因素。 台灣陽明大學內科教授江晨恩指出，司達汀類藥物可能的副作用包括惡心、便秘、腹痛、肌痛、無力，研究對象皆有嚴格監控副作用，一般服用司達汀藥物者，仍應定期檢測肌肉痠痛、肝功能等，出現副作用須換藥。 2008-11-19 Lipid lowering to reduce the risk of cardiovascular disease LIU Hui-min】 【annual meeting of the American Heart Association (AHA) held in New Orleans in the United States, five years of "Jupiter (JUPITER)" an official study published a few days ago, against the normal cholesterol but high-sensitive C-reactive protein (hs-CRP) have continued High above the 50-year-old men, women over the age of 60, if the Secretary to grant class of statin (Statin) lowering drugs can effectively reduce the risk of cardiovascular disease. "Jupiter (JUPITER)" by the Reagan cloth and Women's Hospital heart scholar Rui Deke (Ridker) chaired from 2003 until March of this year, the results have been published in the New England Journal of Medicine, is a 26 across the country, research Object-up to 17,802 people, double-blind clinical trials. CRP as the normal figure of 2 to study for men over the age of 50, women over the age of 60, normal cholesterol value, but the CRP value of 4.2, the continued use of lowering drug Rosuvastatin, a daily 20 mg, compared to placebo group, to reduce Low-density cholesterol (LDL, so-called bad cholesterol) values, and to reduce heart disease, stroke and cardiovascular disease mortality risk of 47% of the total mortality rate decreased by 20%. The United States each year one million people die of cardiovascular disease, the medical community in the past confirmed that 1% lower LDL, and cause atherosclerosis, blocking, leading to cardiovascular disease also reduce the risk of 1%. Rui Deke, and other scholars have found to reduce the risk of cardiovascular disease, in addition to lowering cholesterol, but also reduce inflammation and the concentration of CRP, recent study found that cholesterol in the normal range, but high CRP may also lead to cardiovascular disease, CRP highest Ethnic groups compared to the minimum, the risk of suffering from cardiovascular disease than 2-4 times. President of the AHA Gedeng (Gardner) said, AHA 2003 will be classified as CRP vascular inflammation, cardiovascular disease-related targets. And the "Jupiter" studies have shown that statin drug at the same time reduce the Secretary bad cholesterol and CRP, the study also reaffirmed that. AHA to participate in the annual meeting of the Mackay Memorial Hospital cardiology director of the Jia-Yin Hou said that the "Jupiter" from the CRP confirmed that the "reference" has become a risk factor for cardiovascular disease, and smoking, high blood pressure, cholesterol and for primary prevention must be strictly controlled . Taiwan's Yang Ming University professor of internal medicine Chern-En Chiang pointed out that the Secretary statin drugs side effects may include nausea, constipation, abdominal pain, myalgia, weakness, the study have strict monitoring side effects, the Secretary General to take statin drugs on a regular basis should detect muscle Pain, liver function, and so on, appear to be side-dressing. 2008-11-19 View more information, see the World Journal reported that e-ePaper.

瀏覽更多新聞，請看世界日報電子報 ePaper。