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Biomedical subjects

D T Nash

Publications and source records attributed to D T Nash.

At least 55 records · Page 3Linked to original sources
PubMed1983

Gemfibrozil in combination with other drugs for severe hyperlipidemia. Preliminary study comprising four cases.

In this very early report, Dr Nash shares his insights into a newly developing approach to hyperlipidemia therapy. Four severely hyperlipidemic patients in whom maximum dietary therapy had proved ineffective showed a dramatic reduction in cholesterol and triglyceride levels when treated with multiple drugs, including gemfibrozil. These cases demonstrate that maximally effective polypharmacy can have striking results in selected patients. These provocative findings should encourage other investigators to verify or refute them.

Adult↗
PubMed1982

Effect of lipid-lowering therapy on the progression of coronary atherosclerosis assessed by scheduled repetitive coronary arteriography.

We studied 42 subjects, each of whom demonstrated significant (greater than or equal to 50%) narrowing of a non-grafted coronary artery and a baseline cholesterol level greater than 250 mg%. All patients underwent repeat scheduled coronary arteriography after 2 years on the study. Twenty-five colestipol responders (cholesterol levels reduced at least 15% within 1 month of therapy) were compared to 17 non-responders who were given 23 months of placebo after a 1 month exposure to colestipol. Baseline risk factors and demographic characteristics were similar for the two groups. In comparison to baseline arteriography, only 3 of the 25 drug-treated patients showed progression, while 8 of 17 placebo treated patients demonstrated progression (P = 0.011). Drug-treated patients demonstrated a 20% decrease in cholesterol levels, while placebo patients did not experience a significant reduction in cholesterol levels. Our study suggests that significant reduction in serum cholesterol levels is associated with a reduced likelihood of progression of coronary atherosclerotic lesions assessed by scheduled repetitive coronary arteriography in hyperlipidemic subjects demonstrating significant coronary artery narrowing on their initial arteriograms.

Cholesterol↗
PubMed1982

Hyperlipidemia therapy: can it prevent coronary atherosclerosis?

Improvements in diagnosis permit primary care physicians to identify lipid disorders. Until recently, most of the therapy for coronary artery disease was directed at the symptoms produced by the ischemic myocardium. As more studies reveal the close relationship between the presence of abnormal lipid levels and the prevalence and progression of coronary artery disease, physicians who care for coronary patients should pay closer attention to the possibility of preventing or attenuating progression of the disease. The development of effective drugs represents an initial phase in long-range resolution of the problem of progressive vascular disease. While dietary management is important, pragmatic considerations suggest that modification of serum lipids to ideal levels will require the use of polypharmacy.

Cholesterol↗
PubMed1982

Effect of high-chromium brewer's yeast on human serum lipids.

A group of 11 normolipidemic and a group of 16 hyperlipidemic adult subjects were given orally 20 gm daily of a high-chromium brewer's yeast (2.4 micrograms Cr+++/gm, ie, 48 micrograms Cr+++ daily) for 8 weeks. A significant decrease in total cholesterol in both groups of subjects was observed (24-26 mg/dl). High density lipoprotein cholesterol (HDL-C) was significantly increased (5-6 mg/dl) in normo- and hyperlipidemic subjects by brewer's yeast supplementation. However, following supplementation, the triglyceride blood levels were not changed in either the normo- or hyperlipidemic group. When the multiple complex risk factor (total cholesterol/HDL-C) was calculated, 84% of all subjects receiving brewer's yeast showed a decrease in this ratio, and the mean decrease in this ratio in all subjects was significant at P less than 0.01. A second group of 19 normolipidemic, predominantly male, adult subjects was given orally 10 gm of a high-chromium brewer's yeast (2.4 micrograms/gm, ie, 24 micrograms Cr+++ daily) for 8 weeks. The total circulating serum cholesterol was significantly decreased by a modest amount in this group after supplementation. The HDL-C levels were significantly increased (4 mg/dl). The total cholesterol/HDL ratio was decreased in 79% of the subjects, and the mean TC/HDL-C decrease of the entire group was significant at P less than 0.01.

Adult↗
PubMed1982

Hyperlipoproteinemia, atherosclerosis and gemfibrozil.

Elevated levels of serum cholesterol have long been associated with an increased risk of both the occurrence and the progression of coronary atherosclerosis. The use of dietary therapy to reduce elevated lipid labels has received widespread attention, but like other therapy requiring behavioral modification has met with only partial success in most patients. Little wonder that drugs which lower lipids have been utilized to supplement the effect of diet in hyperlipidemia subjects. Currently available hypolipidemic agents are far from ideal in their effectiveness and lack of side effects, so the search for more potent, safer drugs has been intense. This paper reports on the use of one such agent, gemfibrozil; and its comparison with clofibrate and placebo. Gemfibrozil (CL719, 2,2-dimethyle-5-(2,5 xylyloxy) valeric acid is a substituted phenoxy alkyl acid which has been shown to decrease lipids in hyperlipidemia subjects. A short term study using 1200 mg of gemfibrozil daily demonstrated reduction in total serum cholesterol, triglyceride and apo B levels, and a concomitant rise in HDL cholesterol levels. A long term study of the effect so gemfibrozil showed that the drug had a more pronounced effect on triglyceride then cholesterol, that it had few side effects and the effect was sustained. A recent study from New Zealand demonstrated that gemfibrozil, compared to placebo, lowered plasma cholesterol, triglyceride and VLDL levels and raised HDL levels.

Adult↗
PubMed1980

Gemfibrozil--a new lipid lowering agent.

Thirty patients with type II and IV hyperlidemia were studied by a double blind cross over technic. Gemfibrozil at dosages of 1200 mg and 1600 mg a day was compared to 2000 mg daily of clofibrate. The effect of each drug regimen is described for the entire study population and for those who were found to be responders.

Cholesterol↗
PubMed1978

Relationship of age and biomedical risk factors to progression of coronary artery disease.

The relationship between age, biomedical risk factors and the progression of occlusive disease of the coronary arteries was studied in 176 patients (age range, 27-66 years) who had undergone at least two cine angiograms. The biomedical risk factors of interest were serum concentrations of cholesterol and triglycerides, smoking, hypertension, diabetes mellitus, family history of coronary disease, electrocardiographic abnormalities, obesity, and age. The findings did not reveal any significant differences in mean lipid levels between patients showing progression of disease and those who did not. However, the distribution of serum cholesterol values indicated more hypercholesterolemic patients among the disease-progression group, and more patients with ideal cholesterol levels among the no-progression group. The other biomedical variables did not appear to be related to the progression of coronary disease. Among the older patients, hypercholesterolemia and diabetes mellitus were related to disease progression. Among the younger patients, smoking was related to progression.

Adult↗
PubMed1977

The Erysichthon syndrome. Progression of coronary atherosclerosis and dietary hyperlipidemia.

One hundred nineteen patients with coronary artery disease confirmed by coronary arteriograms were studied. Cine coronary arteriography confirmed progression of atherosclerosis in 106 (89%) patients (mean age 50.9 yr) and nonprogression in 13 (11%) patients (mean age 50.3 yr). Progression was defined as follows: any increase to 50% stenosis, 50% to 75% narrowing, 75% to 90%, 90% to 99%, 99% to total occlusion. Only one patient of the 106 who progressed (less than 1%) had ideal values for both cholesterol and triglyceride. Three of 13 patients (23%) who did not progress had ideal lipid values (P less than 0.005). Fifty four of 106 patients who progressed had cholesterol levels greater than or equal to 250 mg%; none of 13 patients who did not progress had such levels (P less than 0.005). Thirty-nine of 98 (40%) patients who progressed had hypertension; only one (8%) who did not progress had hypertension (P less than 0.025). Seventy-four of 96 patients who progressed were smokers (77%); two of 13 nonprogression patients smoked (15%) (P less than 0.005).

Adult↗
PubMed1977

Antihypertensive effect and serum potassium homeostasis: comparison of hydrochlorothiazide and spironolactone alone and in combination.

Hydrochlorothiazide (HCT) and spironolactone (SP), alone and in combination, were utilized in the treatment of 79 adult men with mild to moderate essential hypertension. Comparative effects were determined with regard to anti-hypertensive action, serum potassium homeostasis and BUN. Both HCT and SP, alone and in combination, produced significant anti-hypertensive effects. Anti-hypertensive response to SP was clearly dose-related. All medications produced a moderate and transient elevation of BUN. The most marked differences were observed with regard to serum potassium levels (K). HCT produced a marked decrease in K which persisted through 12 weeks of therapy. SP produced moderate dose-related elevations of K which reverted toward baseline levels between the 4th and 12th weeks of treatment. The "safety advantage" of SP is discussed relative to its role in producing K homeostasis due to its unique mechanism of action.

Adult↗
PubMed1976

[Hypolipidemic effects of DH581 during prolonged administration (author's transl)].

A new cholesterolol lowering agent, DH581, has been studied in eighteen patients with elevated cholesterol levels for more than one year. The data showed twelve patients studied as being cholesterol responders with an overall decrease of 21%. The Placebo period had an overall rise in cholester with a return of effect after re-administration of the drug. During the remainder of the study period, responders had a 17% decrease in cholesterol. Non-responders varied widely but did not demonstrate a significant cholesterol decrease. Triglyceride levels demonstrated wide fluctuation. Nine responders of eighteen patients studied had an overall decrease of 32% and the remainder demonstrated an increase in triglyceride values. Weight changes were not significant and did not account for the observed changes. There was no consistent relationship of sex to the observed response. DH581 appears to be effective antyhypercholesterolemic drug of low toxicity.

Adolescent↗
PubMed1975

Probucol, a new cholesterol lowering drug.

The purpose of this investigation was to determine the ability of Dh-581 (Procubol) (See Figure 1) to reduce the level of serum cholesterol for extended periods of time and to maintain the reduction without loss of effectiveness. The effects of DH-581 on triglycerides and the safety and tolerance of daily doses were also assessed.

Anticholesteremic Agents↗