Stopping the world’s top killer

Wary of eating fast food that’s rich in fat, yet can’t seem to find the will power to avoid them? Perhaps it might be helpful to know that the incidence of coronary artery disease (CAD) has reached epidemic proportions, making it a consistent top killer worldwide.

CAD develops when there is plaque buildup in the arteries, thus diminishing the supply of oxygen and nutrients to the heart. This may eventually lead to angina (chest pain) or sudden death.

Standard therapeutic approaches are usually confined to targeting elevated levels of bad cholesterol or low-density lipoprotein (LDL), and to some extent, triglycerides (another fat lipid). Long-acknowledged predictors of CAD, both of these culprits work to build destructive plaques.

Yet, while scientific trials on statin have shown significant reductions in CAD mortality, majority of the patients still suffered from cardiovascular events, prompting a challenge to go beyond a mere LDL-lowering approach.

The Framingham Study suggests that a low level of high-density lipoprotein (HDL), also known as the good cholesterol, poses a major risk factor for CAD.

High-density lipoprotein (HDL) induces the removal of cholesterol from the cells and has a direct beneficial effect on the arterial wall. Therapy with fibrates, or fibric acid derivatives, effectively boosts HDL levels and lowers plasma triglycerides in patients with metabolic syndrome and diabetes mellitus type 2.

Studies revealed that fibrates can decrease triglycerides by up to 50 percent and enhance HDL by 10-15 percent.

Fenofibrate, according to Prof. John Chapman of the Hospital de la Pritie in Paris, France, has been shown to significantly increase the good HDL cholesterol while reducing LDL, total cholesterol and fibrinogen levels, thus setting it apart from other kinds of fibrates.

As demonstrated in the landmark Diabetes Atherosclerosis Study (DAIS), fenofibrate can significantly reduce progression of coronary artery stenosis in patients with lipid abnormalities and diabetes.

A high level of HDL has been shown to protect against CAD and according to Chapman, HDL cholesterol transfers bad cholesterol to the liver in a unique process called "reverse cholesterol transport," clearing potentially atherogenic fatty elements from the circulation.

HDL also appears to have anti-inflammatory, anti-infection and antioxidant properties that further enhance its beneficial effects to prevent CAD.

When used together with statins in combination therapy, it was found that fenofibrate, unlike gemfibrozil (another fibrate), has high therapeutic efficiency and remarkably low frequency of adverse effects. Fenofibrate can be used in treating high-risk patients who do not respond well to monotherapy.

Fenofibrate is an original product of Laboratoires Fournier, a pharmaceutical company noted for its technological innovation in developing drugs for the treatment of diabetes, obesity, dyslipidemia and atherosclerosis. It should only be used upon the advice of a physician.