The cholesterol wars : the skeptics vs. the preponderance of evidence / Daniel Steinberg.

Format:

Book

Author/Creator:

Steinberg, Daniel, 1922-2015.

Language:

English

Subjects (All):

Atherosclerosis.

Anticholesteremic agents.

Statins (Cardiovascular agents).

Physical Description:

1 online resource (253 p.)

Edition:

1st ed.

Place of Publication:

San Diego, Calif. : Academic Press, 2007.

Language Note:

English

Summary:

Today, in the era of the statins (cholesterol lowering drugs), there is no longer any doubt about the value of lowering blood cholesterol levels. This book chronicles the controversy that swirled around the 'lipid hypothesis' of atherosclerosis for so many years. In fact, 'the lower the better' is the position of many clinicians. However, getting to this point has been a long uphill battle marked by heated debate and sometimes violent disagreement. The history of this controversy is told here for its own sake and because remembering it may help us avoid similar mistakes in the future.

Contents:

Front Cover; The Cholesterol Wars: The Skeptics vs. the Preponderance of Evidence; Copyright Page; Contents; Foreword; Preface; Acknowledgments; Chapter 1. Overview; On the nature of medical controversy; An overview of the cholesterol wars; Where we stand today; References; Chapter 2. Animal Models of Atherosclerosis; Nikolai N. Anitschkow and the cholesterol-fed rabbit; Why wasn't Anitschkow's lead followed up?; What led Anitschkow to feed rabbits cholesterol?; Atherosclerosis in other species; Notes; References

Chapter 3. Hypercholesterolemia and Atherosclerosis in Humans: Causally Related? The clinical and genetic evidence; Do more modest degrees of hypercholesterolemia, such as are found in a general population, confer risk of premature coronary heart disease?; The epidemiologic evidence; Dietary fat, blood cholesterol, and coronary heart disease; Do diets rich in saturated fats really raise blood cholesterol?; Experimental findings; Observational studies; The contribution of dietary cholesterol intake; Early clinical trials of dietary intervention; Additional pre-1970 studies

Overview of all of the pre-1970's diet intervention studies A brief wrap-up of the case against cholesterol as of 1970; Note; References; Chapter 4. Building the Basic Science Foundation; The biosynthesis of cholesterol and its metabolic regulation; The rate-limiting step, HMGCo A reductase; The birth of the lipoproteins and the John W. Gofman story; Unraveling the complex metabolism and interactions of the plasma lipoproteins; Which lipoproteins are proatherogenic?; The National Heart Institute story; Bringing the lipoprotein package concept into clinical practice

Moving from phenotype to genotypeReferences; Chapter 5. In Search of a Pathogenesis; The importance of understanding mechanism in gaining acceptance of a hypothesis; Early attempts to define the pathogenesis of atherosclerosis; The response-to-injury hypothesis and the monoclonal hypothesis; Understanding the role of HDL as an atheroprotective factor; An update on HDL as a target for intervention; Discovery of the LDL receptor: the remarkable partnership of Brown and Goldstein; Goldstein and Brown start their search for the faulty gene in familial hypercholesterolemia

Discovery of the scavenger receptor on macrophages Oxidatively modified LDL and atherogenesis; Inflammation in the pathogenesis of atherosclerosis; Weighing the relative importance of inflammation and hyperlipidemia; Regression of atherosclerosis; Status of the lipid hypothesis in the 1980's; Note; References; Chapter 6. The Search for Cholesterol-lowering Drugs; Hypocholesterolemic drugs as a target: cons and pros Nicotinic acid; Bile acid-binding resins; Clofibrate; Probucol; Another blow: the somewhat messy Coronary Drug Project; The cholesterol controversy at its height; References

Chapter 7. The 1984 Coronary Primary Prevention Trial

Notes:

Description based upon print version of record.

Includes bibliographical references and index.

ISBN:

1-281-11191-0

9786611111915

0-08-055619-1

OCLC:

476125905