Word: ldl
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Dates: during 1980-1989
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...advised to watch their diet and be retested annually. Individuals with levels of 240 mg/dl or more are at high risk and require medical attention, including a second test to determine the ratio of "good" cholesterol (high-density lipoprotein, or HDL) to "bad" cholesterol (low-density lipoprotein, or LDL). People in the borderline range who have additional risk factors, such as smoking, being male, or having a family history of heart disease, are advised to follow the same routine as those at high risk...
...pair spent much of the 1970s painstakingly deciphering how the body regulates cholesterol levels. Just as oil and water cannot mix without a detergent, cholesterol cannot enter the bloodstream unless it is ferried within a complex of molecules called low-density lipoprotein, or LDL. The Texas researchers found that the LDL ferries travel to docks called LDL receptors. More important, they learned that low cholesterol levels in the liver trigger the production of more receptors, which pull LDL out of the blood. But if the liver does not make enough receptors, the LDL levels in the blood will rise...
Merck proceeded to develop lovastatin in earnest. Over the next four years the drug was tested on 750 people. Result: their LDL levels dropped by 19% to 39%. Although other drugs, such as cholestyramine and nicotinic acid, can reduce cholesterol levels significantly, they seem to work best on people whose levels are not very high. Lovastatin's greater effectiveness, Grundy explains, lies in its ability to inhibit cholesterol production in the liver, preventing further arterial blockage...
...halted by diet, drugs and exercise aimed at controlling cholesterol levels. But a few tantalizing studies have suggested that if levels are reduced drastically enough, plaque may actually begin to melt away. Only in the past few years have doctors had the tools to achieve such reductions. LDL-pheresis is one example, while new experimental drugs like Mevinolin, particularly when combined with existing drugs, also hold great promise. "What's exciting now," observes Biochemist Thomas Parker, director of the Rogosin lipid laboratory, "is that for the first time researchers all over the world can begin to study the possibility...
Though patients undergoing LDL-pheresis have suffered few side effects, the long-term consequences are unknown. There is a theoretical risk, doctors say, that antibodies in the filter could leach out into the blood and cause allergic reactions. Many believe the inconvenience and expense of the procedure will limit its applicability. Dr. Antonio Gotto, a leading lipid researcher, estimates that a year of weekly treatments would cost $40,000. Even an LDL-pheresis enthusiast like Chazov agrees that it is not "a means of mass treatment for atherosclerosis." For that, he says, one must turn not to miraculous medical intervention...