CORRECTION OF DYSLIPIDEMIA: HISTORICAL ASPECT AND MODERN PERSPECTIVE ON THE PROBLEM (REVIEW, PART I)

Abstract

Aim. To conduct a generalization of scientific research on the history of the use of medications for the correction of dyslipidemia in clinical practice. Materials and methods. The analysis and generalization of scientific articles, guidelines and recommendations on the justification and implementation of the appointment of hypolipidemic drugs for the treatment and prevention of cardiovascular diseases (CVD) was carried out. The methods used were: systematic approach, bibliosemantic, analytical. Results. Hypotheses regarding the role of hypercholesterolemia in the development of atherosclerotic lesions of the cardiovascular system were proposed as early as the second half of the 19th century, and scientific approaches regarding the need to correct dyslipidemia were substantiated only with the introduction of the concept of risk factors in the second half of the 20th century. However, it took almost two decades for the introduction of hypolipidemic drugs for the prevention and treatment of CVD into clinical practice. The first pharmacological drug that began to be used in clinical practice was nicotinic acid (niacin). Bile acid sequestrants (cholestyramine, colestipol, colesevelam) became the second group, and fibrates (fenofibrate, bezafibrate, gemfibrozil, and ciprofibrate) became the third group of hypolipidemic therapy drugs. Later, these drugs gave way to statins, whose clinical effectiveness was higher and the safety profile was better. Statin therapy is generally well tolerated and adverse reactions occur in less than 5% of randomized clinical trials. At the current stage, statins remain first-line drugs for the correction of lipid metabolism. The evidence base for statins is significant, and the results of randomized clinical trials have demonstrated the effectiveness of this group of drugs in the secondary and primary prevention of CVD. Since the end of the 90s of the 20th century, there has been a steady increase in the prescription of statins in clinical practice. Сonclusions. Medications for the correction of dyslipidemia have been used in clinical practice since the second half of the 20th century. Niacin, fibrates, and bile acid sequestrants have now been replaced by statins, which remain the first-line drugs for the correction of lipid metabolism.

Keywords

• dyslipidemia
• cardiovascular diseases
• statins
• niacin
• fibrates
• bile acid sequestrants