Ateroskleróza

Richard Češka

Vnitr Lek 2016, 62(11):855  

Hypertension and hypercholesterolemia in the Czech population

Peter Wohlfahrt, Alena Krajčoviechová, Jan Bruthans, Renata Cífková

Vnitr Lek 2016, 62(11):863-867  

Introduction:Hypertension and hypercholesterolemia are inter-related ad mutually potentiating cardiovascular risk factors, which, when occurring together, strongly accelerate atherosclerosis and significantly increase cardiovascular risk. The aim of our study was to assess the prevalence and control of both risk factors in the Czech population. Methods:A 1 % population random sample aged 40-64 years was examined within the Czech post-MONICA in 2006-2009. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg or use of antihypertensive medication. Hypercholesterolemia...

Genetic determination of dyslipidemia - What tell us the results of genome-wide association studies?

Jaroslav Alois Hubáček

Vnitr Lek 2016, 62(11):868-876  

Dyslipidemia (high levels of plasma triglycerides and total cholesterol/LDL-cholesterol and low HDL-cholesterol) is considered as one of the major factors in the development of atherosclerosis and subsequent myocardial infarction. The final value of lipid parameters results from joint action of genetic predispositions and lifestyle factors (primarily smoking status, physical activity and in lower extent also diet). It is estimated that genetic factors are responsible for 40-80 % of the variability of plasma lipid values. Currently are as predictors DL analyzed mainly single nucleotide polymorphisms (SNPs). A fundamental shift in knowledge of genetic...

Molecular genetics of hypercholesterolemia

Lucie Schwarzová

Vnitr Lek 2016, 62(11):877-881  

The review focuses on the molecular background of an inborn error of lipid metabolism -familial hypercholesterolemia. FH describes a group of genetic defects resulting in severe elevations of blood cholesterol levels and increased risk of premature coronary heart disease. Most cases are due to the mutations decreasing and/or destroying the function of the LDL receptor (85-90 % of cases), smaller portion of cases is caused by defects in the gene encoding the ligand for LDL receptor - apolipoprotein B-100 (5-10 %). Less than 5 % of cases has gain-of-function station of the PCSK9 gene that increases the rate of degradation of the LDL receptor molecules....

Hyperlipoproteinemia in children

Zuzana Urbanová

Vnitr Lek 2016, 62(11):882-886  

Hyperlipoproteinemia (HLP) is one of the most common metabolic disorder in childhood. We assume that 20 % of children have a disorder of the lipid metabolism. Some HLP are very common in the population, and moderate, and some are very rare, but are very severe. These may occur secondary to pathological conditions, or are formed on the basis of the primary monogenic or polygenic disorders of lipid metabolism. The detection of children with HLP in the Czech Republic is either random, or more often by selective screening of children with familial history of cardiovascular disease, provided by general pediatric practitioners for children and adolescents....

Hyperlipoproteinemia and dyslipidemia as rare diseases. Diagnostics and treatment

Richard Češka, Tomáš Štulc, Lucie Votavová, Lucie Schwarzová, Martina Vaclová, Tomáš Freiberger

Vnitr Lek 2016, 62(11):887-894  

Hyperlipoproteinemia (HLP) and dyslipidemia (DLP) are of course mainly perceived as diseases of common incidence and are typically seen as the greatest risk factors (RF) in the context of the pandemic of cardiovascular diseases. This is certainly true and HLP or DLP overall affect tens of percents of adults. However we cannot overlook the fact that disorders (mostly congenital) of lipid metabolism exist which, though not formally defined as such, amply satisfy the conditions for classification as rare diseases. Our account only includes a brief overview of the rare HLPs based on the dominant disorder of lipid metabolism, i.e. we shall mention the rare...

Severe familial hypercholesterolemia treatment

Michal Vrablík, Tomáš Freiberger, Vladimír Bláha, Richard Češka

Vnitr Lek 2016, 62(11):895-901  

Familial hypercholesterolemia (FH) represents the most frequent of inborn errors of metabolism. It is a group of disorders with a codominant mode of inheritance characterized by marked elevations of LDL-cholesterol as well as atherosclerotic cardiovascular disease risk. Clinical (phenotypic) picture of FH varies widely depending on genotype and concomitant risk factors. Identification of most seriously affected FH individuals is necessary for proper clinical management. The therapeutic approach must be complex and comprehensive. The corner stone of pharmacotherapy is high-intensity statin therapy usually combined with ezetimibe (possibly complemented...

How to deal ugly twins, LDL-cholesterol and lipoprotein (a)

Jan Piťha

Vnitr Lek 2016, 62(11):903-907  

LDL cholesterol (LDL-C) remains the primary goal for hypolipidemic therapy as a representative of atherogenic LDL particles. In patients at very high risk, its level should be in the range 0.9-1.6 mmol/l. In patients with progression of atherosclerosis despite treatment, an important role could play high level of lipoprotein (a) - Lp(a), particle with a high atherothrombotic potential. Until now, it was difficult to reduce LDL-C to the desired range by recent therapy: combination of lifestyle changes, high doses of strong statins and ezetimibe. Lp(a) was not affected by these measures at all. Recently, we have the opportunity to reduce significantly...

Diabetes and dyslipidemia: Why are they so closely related?

Katarína Rašlová

Vnitr Lek 2016, 62(11):908-911  

Diabetes mellitus is a group of metabolic diseases that are characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The cause of premature death among patients with diabetes predominantly involves cardiovascular diseases. The risk of death from cardiovascular complications is so high that diabetes mellitus is considered a risk equivalent to a manifest atherosclerotic disease. High cardiovascular risk is also determined by dyslipidemia which is present in a large number of patients with diabetes. The review is devoted to the pathogenesis of dyslipidemia in type 1 and type 2 diabetes with an emphasis on atherogenic...

A diet suitable for patients with dyslipidemia and metabolic syndrome

Lukáš Zlatohlávek, Štěpán Svačina

Vnitr Lek 2016, 62(11):912-918  

Atherosclerosis or cardiovascular disease is the leading cause of mortality and morbidity in developed countries. Intervention of its risk factors is pharmacological but non-pharmacological intervention must be its integral part. Dietary recommendations for dyslipidemia are long known however it is necessary to emphasize the importance of their compliance. Presently, these recommendations for adult population to prevent from atherosclerosis are based on healthy nourishment, especially to have sufficient consumption of fish, fresh vegetable and fruit and to avoid consumption of secondary processed meat especially, i.e. smoked meat. Nowadays, there is...

Uric acid as a risk factor for cardiovascular diseases

Ľubica Cibičková, David Karásek

Vnitr Lek 2016, 62(11):919-923  

According to current knowledge, uric acid plays an important role in pathogenesis of civilizational diseases - obesity, metabolic syndrome and cardiovascular diseases. Uric acid has become an independent risk factor of morbidity and mortality. It is questionable, if the relationship between uric acid and cardiovascular diseases is direct (through influence on endothelial dysfunction, oxidative stress and inflammation) or indirect (mediated by known risk factors of cardiovascular diseases - metabolic syndrome, obesity, insulin resistance and hypertension). This article describes relationship between particular cardiovascular risk factors and uric acid....

Familial hypercholesterolemia in the Czech Republic in 2016

Tomáš Freiberger, Martina Vaclová, Lukáš Tichý, Vladimír Soška, Vladimír Bláha, Lenka Fajkusová, Richard Češka, Michal Vrablík

Vnitr Lek 2016, 62(11):924-928  

Familial hypercholesterolemia (FH) is the most frequent autosomal dominant hereditary disease which is characterized by a decreased LDL-cholesterol catabolism and early clinical manifestation of atherosclerosis affecting blood vessels. The MedPed (Make early diagnosis to Prevent early deaths) project aims to diagnose patients with FH as early as possible, so that they can profit the most from a therapy started in a timely manner and avoid premature cardiovascular events. Currently, as of 31 October 2016, the Czech national database keeps records of 6 947 patients with FH from 5 223 families. Considering the prevalence of FH equalling 1 : 250, this...

Rajko Doleček et al. Endokrinologie traumatu

Štěpán Svačina

Vnitr Lek 2016, 62(11):949  

Lukáš Zlatohlávek et al. Klinická dietologie a výživa

Petr Sucharda

Vnitr Lek 2016, 62(11):950  

Notes on the HOPE-3 study

Vladimír Soška

Vnitr Lek 2016, 62(11):929-932  

The study HOPE-3 aimed to determine whether treatment with statin and with antihypertensive drugs (candesartan and hydrochlorothiazide) in routine clinical practice in people without cardiovascular diseases (men aged over 55, women over 65 years) will reduce cardiovascular events. Another objective was to answer whether the effect of the above-mentioned treatment will be the same in different ethnic (anthropometric) populations. All drugs were administered as an "polypills". The study demonstrated that use of antihypertensive medication in this population does not reduce the incidence of cardiovascular events. In contrast, statin treatment reduced...

The SPRINT study - the outcomes of the most important study over the recent period focused on hypertension

Miroslav Souček

Vnitr Lek 2016, 62(11):933-937  

When treating systolic hypertension we do not know the optimum blood pressure which leads to the reduction of cardiovascular events and cardiovascular and total mortality. The results of the ACCORD study, when comparing intensive treatment of systolic blood pressure < 120 mm Hg and standard treatment < 140 mm Hg, did not lead to affecting the primary target for patients with diabetes mellitus. In the autumn last year the SPRINT study was presented and published, showing favourable impact on the combined primary target, which involved myocardial infarction, other acute coronary syndromes, stroke, heart failure or death from cardiovascular causes...

Diabetologický den. Pokroky v diagnostice a terapii diabetes mellitus 2016. Prof. MUDr. Jaroslav Rybka, DrSc., slaví 85. narozeniny

Alena Adamíková

Vnitr Lek 2016, 62(11):939-941  

Európsky kardiologický kongres - poruchy metabolizmu lipidov

Ján Murín

Vnitr Lek 2016, 62(11):942-944  

XIV. slovenské obezitologické dni s medzinárodnou účasťou. Nové pohľady na komplexný manažment pacienta s obezitou (1. časť)

Michal Pečík

Vnitr Lek 2016, 62(11):945-948  

Prof. MUDr. Jaroslav Rybka, DrSc., slaví 85. narozeniny

Štěpán Svačina

Vnitr Lek 2016, 62(11):938