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Densham E, Youssef E, Ferguson O, Winter R. The effect of statins on falls and physical activity in people aged 65 and older: A systematic review. Eur J Clin Pharmacol 2024; 80:657-668. [PMID: 38353691 DOI: 10.1007/s00228-024-03632-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/18/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE Statins are commonly prescribed medications with recognised side effects including muscle weakness. Despite this, little is known about their effect on the physical activity and falls risk in the older population. This paper aims to explore the relationship between statin use and the physical activity and falls risk in adults aged 65 and older. METHODS MEDLINE, Embase, CINAHL and PsycINFO were searched on 21/11/2022 to obtain relevant articles. Data considered appropriate included that relating to muscle strength, grip strength, gait speed, balance and falls incidence. Reference and citation searches were performed to identify further relevant papers, and all eligible articles were subject to a Critical Appraisal Skills Programme (CASP) to assess potential bias. With the data being highly heterogeneous, no attempt to measure effect size was made and a narrative synthesis approach was used. The review proposal was registered with PROSPERO: CRD42022366159. RESULTS Twenty articles were included. Data were inconsistent throughout, with the overall trend suggesting no significant negative effects of statins on the parameters of physical activity, or on falls risk. This was especially true in matched and adjusted cohorts, where potential confounders had been accounted for. CONCLUSION This review did not identify a relationship between statin use and physical activity and falls risk in people aged 65 years and older. Ultimately, the risks and benefits of every medication should be considered in the context of each individual.
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Affiliation(s)
| | | | | | - Rebecca Winter
- Brighton and Sussex Medical School, Brighton, UK
- University Hospitals Sussex, Brighton, UK
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2
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Long Q, Chen H, Yang W, Yang L, Zhang L. Delphinidin-3-sambubioside from Hibiscus sabdariffa. L attenuates hyperlipidemia in high fat diet-induced obese rats and oleic acid-induced steatosis in HepG2 cells. Bioengineered 2021; 12:3837-3849. [PMID: 34281481 PMCID: PMC8806893 DOI: 10.1080/21655979.2021.1950259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Hibiscus sabdariffa. L is folk medicine that is often used for its hypolipidemic and antihypertensive effects; however, the active compound responsible for its anti-obesity effect is presently unknown. Delphinidin-3-sambubioside (Dp3-Sam) is an anthocyanin, was extracted from Hibiscus sabdariffa L. The present research aimed to investigate the role of Dp3-Sam in the prevention of hyperlipidemia in vivo and in vitro. Rats were fed with a standard chow diet (Control group) or high-fat diet (HFD and DP group) for eight weeks. Besides, HepG2 cells were stimulated with 0.2 mM oleic acid, with or without Dp3-Sam (100-200 µg/ml). Lipid profiles were measured by commercial kits. Oil Red O staining was performed to measure the hepatic and intracellular lipid levels. The key genes of lipid metabolism were measured by RT-PCR. In HFD-fed rats, Dp3-Sam reduced the body weight gain, visceral fat, and abdominal fat and decreased hepatic lipid deposits. Dp3-Sam decreased intracellular TG levels and lipid accumulation in oleic acid-treated HepG2 cells. Besides, Dp3-Sam downregulated the mRNA expression of HMG-CoA reductase (HMGCR), sterol regulatory element-binding protein-1 c (SREBP-1 C), fatty acid synthase (FASN), and acetyl-CoA carboxylase (ACC) and upregulated the mRNA expression of cholesterol 7α-hydroxylase (CYP7A1), carnitine palmitoyltransferase1 (CPT1), acyl-coenzyme A oxidase (ACOX), and peroxisome proliferator-activated receptor alpha (PPARα). Dp3-Sam up-regulated the expression of phosphorylation of AMP-activated protein kinase (pAMPK) in HFD-fed rats. Our findings indicated that Dp3-Sam possesses the potential to improve lipid metabolism dysfunction and our results offered evidence for the use of Dp3-Sam as therapy for the prevention of obesity and dyslipidemia.
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Affiliation(s)
- Qionghua Long
- Department of General Medicine, Yanan Hospital of Kunming, Kunming, China
| | - Hongyan Chen
- Department of General Medicine, Yanan Hospital of Kunming, Kunming, China
| | - Wenhui Yang
- Department of General Medicine, Yanan Hospital of Kunming, Kunming, China
| | - Li Yang
- Department of General Medicine, Yanan Hospital of Kunming, Kunming, China
| | - Lijuan Zhang
- Department of Neurology, Yanan Hospital of Kunming, Kunming, China
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Ekeuku SO, Pang KL, Chin KY. Palmatine as an Agent Against Metabolic Syndrome and Its Related Complications: A Review. Drug Des Devel Ther 2020; 14:4963-4974. [PMID: 33235437 PMCID: PMC7680161 DOI: 10.2147/dddt.s280520] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/29/2020] [Indexed: 12/20/2022] Open
Abstract
Palmatine is a naturally occurring isoquinoline alkaloid with various pharmacological properties. Given its antioxidant and anti-inflammatory properties, palmatine may be able to impede the effects of metabolic syndrome (MetS) and its related diseases triggered by inflammation and oxidative stress. This review summarises the existing literature about the effects of palmatine supplementation on MetS and its complications. The evidence shows that palmatine could protect against MetS, and cardiovascular diseases, osteoporosis and osteoarthritis, which might be associated with MetS. These protective effects are mediated by the antioxidant and anti-inflammatory properties of palmatine. Although preclinical experiments have demonstrated the efficacy of palmatine against MetS and its related diseases, no human clinical trials have been performed to validate these effects. This research gap should be bridged to validate the efficacy and safety of palmatine supplementation in protecting humans against MetS and its related diseases.
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Affiliation(s)
- Sophia Ogechi Ekeuku
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Kok-Lun Pang
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
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Langeard A, Saillant K, Charlebois Cloutier E, Gayda M, Lesage F, Nigam A, Bherer L, Fraser SA. Association between Statin Use and Balance in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134662. [PMID: 32610434 PMCID: PMC7369856 DOI: 10.3390/ijerph17134662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 01/03/2023]
Abstract
Background: Several medications have been associated with an increased risk of balance deficits and greater likelihood to sustain a fall, representing a large health and economic issue. Statins are regularly prescribed to prevent strokes and heart attacks, but their impact on balance is unknown. The aim of this paper was to determine whether statin use is associated with poorer balance performances in older adults. Methods: All participants, one group taking statins (n = 34), and the other group not taking statins (n = 31), completed a balance assessment with their eyes closed and their eyes opened on a MatScan Pressure Sensing Mat. Center of Pressure (CoP) velocity, peak-to-peak distance, and standard deviation were collected in both anteroposterior (AP) and mediolateral (ML) directions. Multiple linear regression analyses were performed for each balance outcome, testing the statin use status as a predictor and controlling for appropriate factors including participants characteristics, lipid profile, and cardiovascular disease. Results: After controlling for confounding factors, statin use significantly predicted both CoP ML-Amplitude (β = 0.638, p = 0.004) and ML-Velocity (β = 0.653, p = 0.002) in the eyes-opened condition. Conclusions: The present study detected a negative association between statin use and balance control in the ML direction, suggesting that caution should be taken when prescribing statins in older adults, as this could decrease ML stability and ultimately increase fall and fracture risks.
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Affiliation(s)
- Antoine Langeard
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
- Correspondence:
| | - Kathia Saillant
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Elisabeth Charlebois Cloutier
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Mathieu Gayda
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Frédéric Lesage
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
- Department of Electrical Engineering, Polytechnique Montreal, Montreal, QC H3T 1J4, Canada
| | - Anil Nigam
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Louis Bherer
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Sarah A. Fraser
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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5
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Wang KN, Bell JS, Tan EC, Gilmartin-Thomas JF, Dooley MJ, Ilomäki J. Statin use and fall-related hospitalizations among residents of long-term care facilities: A case-control study. J Clin Lipidol 2020; 14:507-514. [PMID: 32571729 DOI: 10.1016/j.jacl.2020.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 05/15/2020] [Accepted: 05/17/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Statins are associated with muscle-related adverse events, but few studies have investigated the association with fall-related hospitalizations among residents of long-term care facilities (LTCFs). OBJECTIVE The objective of the study is to investigate whether statin use is associated with fall-related hospitalizations from LTCFs. METHODS A case-control study was conducted among residents aged ≥65 years admitted to hospital from 2013 to 2015. Cases (n = 332) were residents admitted for falls and fall-related injuries. Controls (n = 332) were selected from patients admitted for reasons other than cardiovascular and diabetes. Cases and controls were matched 1:1 by age (±2 years), index date of admission (±6 months), and sex. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression, after considering for history of falls, hypertension, dementia, functional comorbidity index, polypharmacy (≥9 regular preadmission medications), and fall-risk medications. Subanalyses were performed for individual statins, dementia, and statin intensity. RESULTS Overall, 43.1% of cases and 27.1% of controls used statins. Statins were associated with fall-related hospitalizations (aOR = 2.24, 95% CI 1.56-3.23), in particular simvastatin (aOR = 2.26, 95% CI 1.22-4.20) and atorvastatin (aOR = 2.08, 95% CI 1.33-3.24). Statins were associated with fall-related hospitalizations in residents with (aOR = 2.34, 95% CI 1.33-4.11) and without dementia (aOR = 2.30, 95% CI 1.46-3.63). There was no association between statin intensity and fall-related hospitalizations (aOR = 0.78, 95% CI 0.43-1.40). CONCLUSION This study suggests a possible association between statin use and fall-related hospitalizations among residents living in LTCFs. However, there was minimal evidence for a relationship between statin intensity and fall-related hospitalizations. Further research is required to substantiate these hypothesis-generating findings.
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Affiliation(s)
- Kate N Wang
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia; School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia.
| | - J Simon Bell
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, New South Wales, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Edwin Ck Tan
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia
| | - Julia Fm Gilmartin-Thomas
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael J Dooley
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jenni Ilomäki
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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6
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Li Y, Yang X, Zou Y, Li J, Sun Q, Jing X, Yang M, Wang S, Dong B. Association between Statin Use and Physical Function among Older Chinese Inpatients with Type 2 Diabetes. J Nutr Health Aging 2020; 24:194-197. [PMID: 32003410 DOI: 10.1007/s12603-019-1305-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Multiple statin-associated muscle symptoms (SAMS) risk factors usually coexist in a given older diabetic patient, but the association between statin use and physical function in older Asian persons with T2MD remains uncertain. The present study therefore sought to provide insight into this uncertainty through a focused assessment of statin-associated outcomes in Chinese diabetic adults. DESIGN Cross-sectional study. SETTINGS AND PARTICIPANTS The study included 146 participants with T2MD in the Center of Gerontology and Geriatric, West China Hospital. MEASUREMENTS The participants received the comprehensive geriatric assessment (CGA). Statin use and other medical data for each patient were determined via assessment of the inpatient hospital information system. Assessments of physical functions included ADLs, IADLs and the Timed "Up and Go" (TUG) test. Multiple regression analyses were then performed in order to determine the relationship between statin utilization and physical function. RESULTS The average age of these 146 participants (32 women, 21.9%) was 80.00±5.60 years. At enrollment, 78 (53.4%) of the 146 patients were treated with statins. Among the statin users, 48.7% presented with a lack of TUG ability, which was significantly greater than in non-statin users (27.9%). However, the rates of IADL and ADL disabilities did not differ significantly between groups. In a multiple regression analyses, statin use was associated with a three-fold (95% CI 1.06, 9.51) increase in the risk of TUG inability, after adjusted all covariates. CONCLUSIONS There was a significant association between statin use and TUG inability in older Chinese inpatients with diabetes.
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Affiliation(s)
- Y Li
- Shuang Wang, MD, The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University. 37 Guoxuexiang, Chengdu, Sichuan providence, PR. China, 610041; Tel: 86-8542 2329; Fax: 86-28-8542 2321; E-mail:
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7
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Juraschek SP, Daya N, Appel LJ, Miller ER, Matsushita K, Michos ED, Windham BG, Ballantyne CM, Selvin E. Subclinical Cardiovascular Disease and Fall Risk in Older Adults: Results From the Atherosclerosis Risk in Communities Study. J Am Geriatr Soc 2019; 67:1795-1802. [PMID: 31493355 PMCID: PMC6733582 DOI: 10.1111/jgs.16041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVES Falls are frequent and often devastating events among older adults. Cardiovascular disease (CVD) is associated with greater fall risk; however, it is unknown if pathways that contribute to CVD, such as subclinical myocardial damage or wall strain, are related to future falls. We hypothesized that elevations in high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), measured in older adults, would be associated with greater fall risk. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS Atherosclerosis Risk in Communities Study participants without known coronary heart disease, heart failure, or stroke. MEASUREMENTS We measured hs-cTnT or NT-proBNP in 2011 to 2013. Falls were identified from hospital discharge International Classification of Diseases, Ninth Revision (ICD-9), codes or Centers for Medicare and Medicaid Services claims. We used Poisson models adjusted for age, sex, and race/study center to quantify fall rates across approximate quartiles of hs-cTnT (less than 8, 8-10, 11-16, and 17 or greater ng/L) and NT-proBNP (less than 75, 75-124, 125-274, and 275 or greater pg/mL). We used Cox models to determine the association of cardiac markers with fall risk, adjusted for age, sex, race/center, and multiple fall risk factors. RESULTS Among 3973 participants (mean age = 76 ± 5 years, 62% women, 22% black), 457 had a subsequent fall during a median follow-up of 4.5 years. Incidence rates across quartiles of hs-cTnT and NT-proBNP were 17.1, 20.0, 26.2, and 36.4 per 1000 person-years and 12.8, 22.2, 28.7, and 48.4 per 1000 person-years, respectively. Comparing highest vs lowest quartiles of either hs-cTnT or NT-proBNP demonstrated a greater than two-fold higher fall risk, with hazard ratios of 2.17 (95% confidence interval {CI} = 1.60-2.95) and 2.34 (95% CI = 1.73-3.16), respectively. In a joint model, the relationships of hs-cTnT and NT-proBNP with falls were significant and independent. CONCLUSION Subclinical elevations of cardiac damage and wall strain were each associated with a higher fall risk in older adults. Further research is needed to determine whether interventions that lower hs-cTnT or NT-proBNP also lower fall risk. J Am Geriatr Soc 67:1795-1802, 2019.
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Affiliation(s)
- Stephen P Juraschek
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Natalie Daya
- The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology, The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Lawrence J Appel
- The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology, The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Edgar R Miller
- The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology, The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Kunihiro Matsushita
- The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology, The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Erin D Michos
- The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology, The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - B Gwen Windham
- Department of Medicine and Center of Biostatistics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Christie M Ballantyne
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
| | - Elizabeth Selvin
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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8
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Musich S, Wang SS, Schwebke K, Slindee L, Waters E, Yeh CS. Underutilization of Statin Therapy for Secondary Prevention of Cardiovascular Disease Among Older Adults. Popul Health Manag 2018; 22:74-82. [PMID: 29893617 PMCID: PMC6386076 DOI: 10.1089/pop.2018.0051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Secondary cardiovascular disease (CVD) clinical trials have demonstrated that higher intensity levels of statin therapy are more effective than lower levels in reducing mortality rates. Despite updated treatment guidelines, statin therapy may be underutilized, with evidence that females are treated less aggressively than males. The primary objective of this study was to determine the prevalence of statin utilization by varying therapy intensity by sex. The secondary objective was to document the benefits of statin therapy intensity levels on all-cause mortality for males and females. A 25% random sample of adults ≥65 years was utilized to identify those with established CVD. Inclusion criteria included: (1) 12-month pre period and (2) up to 30 months post period. Five categories of statin utilization were established: adherent to high-, moderate-, or low-intensity statin therapy, nonadherent, and no statins. Among eligible insureds (N = 49,530 males; N = 44,710 females), 20% of males and 12% of females were identified as high-intensity statin users. Mortality rates significantly increased similarly for males and females as statin therapy intensity decreased. Likewise, mortality hazard ratios indicated the most benefit from high-intensity statin therapy compared to all other categories. Statin therapy for secondary prevention of CVD is beneficial in reducing mortality for males and females but is underutilized, especially among females. Education programs among patients to increase heart health awareness and among physicians to promote the benefits of updated statin guidelines should be encouraged.
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Affiliation(s)
- Shirley Musich
- 1 Research for Aging Populations , Optum, Ann Arbor, Michigan
| | - Shaohung S Wang
- 1 Research for Aging Populations , Optum, Ann Arbor, Michigan
| | - Kay Schwebke
- 2 Informatics & Data Science , Optum, Ann Arbor, Michigan
| | - Luke Slindee
- 2 Informatics & Data Science , Optum, Ann Arbor, Michigan
| | - Evonne Waters
- 3 Medicare & Retirement, UnitedHealthcare Alliances , Minneapolis, Minnesota
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9
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de Vries M, Seppala LJ, Daams JG, van de Glind EMM, Masud T, van der Velde N. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs. J Am Med Dir Assoc 2018; 19:371.e1-371.e9. [PMID: 29396189 DOI: 10.1016/j.jamda.2017.12.013] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 12/15/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Use of certain medications is recognized as a major and modifiable risk factor for falls. Although the literature on psychotropic drugs is compelling, the literature on cardiovascular drugs as potential fall-risk-increasing drugs is conflicting. The aim of this systematic review and meta-analysis is to provide a comprehensive overview of the associations between cardiovascular medications and fall risk in older adults. METHODS Design: A systematic review and meta-analysis. DATA SOURCES Medline, Embase, and PsycINFO. Key search concepts were "fall," "aged," "causality," and "medication." Studies that investigated cardiovascular medications as risk factors for falls in participants ≥60 years old or participants with a mean age of 70 or older were included. A meta-analysis was performed using the generic inverse variance method, pooling unadjusted and adjusted odds ratios (ORs) separately. RESULTS In total, 131 studies were included in the qualitative synthesis. Meta-analysis using adjusted ORs showed significant results (pooled OR [95% confidence interval]) for loop diuretics, OR 1.36 (1.17, 1.57), and beta-blocking agents, OR 0.88 (0.80, 0.97). Meta-analysis using unadjusted ORs showed significant results for digitalis, OR 1.60 (1.08, 2.36); digoxin, OR 2.06 (1.56, 2.74); and statins, OR 0.80 (0.65, 0.98). Most of the meta-analyses resulted in substantial heterogeneity that mostly did not disappear after stratification for population and setting. In a descriptive synthesis, consistent associations were not observed. CONCLUSION Loop diuretics were significantly associated with increased fall risk, whereas beta-blockers were significantly associated with decreased fall risk. Digitalis and digoxin may increase the risk of falling, and statins may reduce it. For the majority of cardiovascular medication groups, outcomes were inconsistent. Furthermore, recent studies indicate that specific drug properties, such as selectivity of beta-blockers, may affect fall risk, and drug-disease interaction also may play a role. Thus, studies addressing these issues are warranted to obtain a better understanding of drug-related falls.
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Affiliation(s)
- Max de Vries
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, The Netherlands; Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Lotta J Seppala
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, The Netherlands; Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Joost G Daams
- Medical library, Academic Medical Center, Amsterdam, The Netherlands
| | - Esther M M van de Glind
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, The Netherlands; Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Nathalie van der Velde
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, The Netherlands; Amsterdam Public Health research institute, Amsterdam, The Netherlands.
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10
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Kawai H, Ihara K, Kera T, Hirano H, Fujiwara Y, Tanaka M, Kojima M, Obuchi S. Association between statin use and physical function among community-dwelling older Japanese adults. Geriatr Gerontol Int 2017; 18:623-630. [DOI: 10.1111/ggi.13228] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/27/2017] [Accepted: 11/13/2017] [Indexed: 01/14/2023]
Affiliation(s)
- Hisashi Kawai
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology; Tokyo Japan
| | - Kazushige Ihara
- Department of Public Health; Toho University School of Medicine; Tokyo Japan
| | - Takeshi Kera
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology; Tokyo Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology; Tokyo Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology; Tokyo Japan
| | - Masashi Tanaka
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology; Tokyo Japan
| | - Motonaga Kojima
- Faculty of Health Sciences; University of Tokyo Health Sciences; Tokyo Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology; Tokyo Japan
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Venegas Sanabria LC, Barbosa Balaquera S, Suarez Acosta AM, García Peña ÁA, Cano Gutiérrez CA. [Statin and risk of falls in the elderly: A sytematic review of the literature]. Rev Esp Geriatr Gerontol 2017; 52:317-321. [PMID: 28728682 DOI: 10.1016/j.regg.2017.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/06/2017] [Accepted: 03/27/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND With the high incidence of cardiovascular events in the elderly population the effectiveness of statins in reducing mortality from coronary events has been demonstrated. However, there have been adverse effects, such as myalgia, myopathy, myonecrosis, not to mention the falls as a result of muscle damage with statin use. OBJECTIVE The purpose of this study is to conduct a systematic review to assess the literature on the association between statin use and the risk of falls. METHODS The databases that were included PUBMED AND SCOPUS, with articles published from January 2000 to May 2016. The MESH terms used for the search were "FALLS" AND "STATIN". Selected studies included cohort populations from the community (>50 years old), and analysed using the Scottish Intercollegiate (SIGN) methodology guidelines, as no randomised controlled study was found. RESULTS In the study by Ham et al., statin use was shown to be a protective factor for presence of falls. In the second study by Scott et al., there was an increased risk of falls (P=.029) and an impairment in muscle strength and quality muscle (P=.033 and P=.046, respectively). In the third study Haerer et al., found an increased risk of falls (P=.63). CONCLUSIONS The association between use of statins and risk of falls could not be determined with the available evidence, although an association with the involvement of some determinants of muscular function was found.
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Affiliation(s)
- Luis Carlos Venegas Sanabria
- Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Unidad de Geriatría, Instituto de Envejecimiento. Semillero de investigación de Neurociencias y Envejecimiento, Bogotá, Colombia.
| | - Stephany Barbosa Balaquera
- Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Unidad de Geriatría, Instituto de Envejecimiento. Semillero de investigación de Neurociencias y Envejecimiento, Bogotá, Colombia
| | - Ana María Suarez Acosta
- Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Unidad de Geriatría, Instituto de Envejecimiento. Semillero de investigación de Neurociencias y Envejecimiento, Bogotá, Colombia
| | - Ángel Alberto García Peña
- Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Unidad de Cardiología, Bogotá, Colombia
| | - Carlos Alberto Cano Gutiérrez
- Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Unidad de Geriatría, Instituto de Envejecimiento. Semillero de investigación de Neurociencias y Envejecimiento, Bogotá, Colombia
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12
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Wang Y, Han Y, Chai F, Xiang H, Huang T, Kou S, Han B, Gong X, Ye X. The antihypercholesterolemic effect of columbamine from Rhizoma Coptidis in HFHC-diet induced hamsters through HNF-4α/FTF-mediated CYP7A1 activation. Fitoterapia 2016; 115:111-121. [DOI: 10.1016/j.fitote.2016.09.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/25/2016] [Accepted: 09/30/2016] [Indexed: 01/04/2023]
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13
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He K, Li X, Xiao Y, Yong Y, Zhang Z, Li S, Zhou T, Yang D, Gao P, Xin X. Hypolipidemic effects of Myrica rubra extracts and main compounds in C57BL/6j mice. Food Funct 2016; 7:3505-15. [PMID: 27459037 DOI: 10.1039/c6fo00623j] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The present study evaluated the antihyperlipidemic activity of myricetin, myricetrin, the alcohol fraction (AF) and the ethyl acetate fraction (EF) obtained from the bark of Myrica rubra (MR) in high-fat and high-cholesterol (HFHC) induced hyperlipidemic C57BL/6j mice. Mice were treated with myricetin, myricetrin, AF and EF with a dose of 130 mg per kg per day for 35 days. After treatment, serum parameters including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), total bile acids (TBA), etc., were examined. The results revealed that EF showed the highest weight lowering activity (P < 0.01). All tested samples decreased the levels of the TC, TG, LDL-C, TBA and LPS (lipopolysaccharide) content in the serum of mice to different extents. Liver fat deposition was significantly reduced after myricetin, myricetrin, AF and EF therapy (P < 0.01). Additionally, the cell size of epididymal adipose tissue was also decreased in myricetin, AF and EF groups (P < 0.05). The antihyperlipidemic activity of these samples may be attributed to the inhibition of lipid synthesis via suppressing the expression of HMGCR (3-hydroxy-3-methylglutaryl coenzyme A reductase) and ACC1 (acetyl-CoA carboxylase), promoting the metabolism and excretion of lipids via up-regulating the expression of SREBP2 (sterol regulatory element binding proteins), LDLR (low density lipoprotein receptor), UCP2 (uncoupling protein 2) and CYP7A1 (cholesterol 7α-hydroxylase). These results may provide a powerful foundation for seeking and utilizing Myrica rubra bio-active compounds for the treatment of hyperlipidemia and cardiovascular diseases.
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Affiliation(s)
- Kai He
- Department of Clinical Laboratory, Hunan University of Medicine, Hunan, 418000, China.
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14
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Retornaz F, Beliard S, Gremeaux E, Chiche L, Lagarde L, Andrianasolo M, Molines C, Oliver C. [Statin and cardiovascular diseases after 75 years]. Rev Med Interne 2016; 37:625-31. [PMID: 27389014 DOI: 10.1016/j.revmed.2016.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/15/2016] [Accepted: 06/02/2016] [Indexed: 11/16/2022]
Abstract
Statin prescription in persons older than 75 years or with frailty signs raises questions on the role of cholesterol in the genesis of atherosclerosis in this population, on the benefit of this treatment in primary or secondary prevention, and on their side effects in a context of multiple pathology and multiple medications. These questions are approached with the available literature data for this population. In secondary prevention, statin prescription is recommended whatever the age although intensive treatment should be avoided. In primary prevention, in the absence of consensus, their prescription depends on both geriatric and cardiovascular risk assessment.
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Affiliation(s)
- F Retornaz
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France; Institut Silvermed, 176, avenue de Montolivet, 13012 Marseille, France; Laboratoire de santé publique, évaluation des systèmes de soins et santé perçue, EA 3279 UFR médecine Aix-Marseille université, 27, boulevard Jean-Moulin, 13385 Marseille Cedex 05, France; Unité de recherche et de soins en médecine interne et maladies infectieuses, hôpital européen, 6, rue Desirée-Clary, 13003 Marseille, France.
| | - S Beliard
- Service d'endocrinologie, CHU de Conception, 47, boulevard Baille, 13005 Marseille, France; Faculté de médecine, boulevard Pierre-Dramard, 13005 Marseille, France
| | - E Gremeaux
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France
| | - L Chiche
- Unité de recherche et de soins en médecine interne et maladies infectieuses, hôpital européen, 6, rue Desirée-Clary, 13003 Marseille, France
| | - L Lagarde
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France
| | - M Andrianasolo
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France
| | - C Molines
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France; Institut Silvermed, 176, avenue de Montolivet, 13012 Marseille, France
| | - C Oliver
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France; Institut Silvermed, 176, avenue de Montolivet, 13012 Marseille, France; Faculté de médecine, boulevard Pierre-Dramard, 13005 Marseille, France
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15
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Peeters G, Tett SE, Hollingworth SA, Gnjidic D, Hilmer SN, Dobson AJ, Hubbard RE. Associations of Guideline Recommended Medications for Acute Coronary Syndromes With Fall-Related Hospitalizations and Cardiovascular Events in Older Women With Ischemic Heart Disease. J Gerontol A Biol Sci Med Sci 2016; 72:259-265. [DOI: 10.1093/gerona/glw111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 05/31/2016] [Indexed: 11/14/2022] Open
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Associations Between Statin Use and Physical Function in Older Adults from The Netherlands and Australia: Longitudinal Aging Study Amsterdam and Australian Longitudinal Study on Women’s Health. Drugs Aging 2016; 33:437-45. [DOI: 10.1007/s40266-016-0370-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Synergetic cholesterol-lowering effects of main alkaloids from Rhizoma Coptidis in HepG2 cells and hypercholesterolemia hamsters. Life Sci 2016; 151:50-60. [PMID: 26876917 DOI: 10.1016/j.lfs.2016.02.046] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 02/02/2016] [Accepted: 02/10/2016] [Indexed: 01/23/2023]
Abstract
AIMS Hyperlipidemia contributes to the progression of cardiovascular diseases. Main alkaloids from Rhizoma Coptidis including berberine (BBR), coptisine (COP), palmatine (PAL), epiberberine (EPI) and jatrorrhizine (JAT), improved dyslipidemia in hypercholesterolemic hamsters to a different degree. In this study, HepG2 cells and hypercholesterolemic hamsters were used to investigate the synergetic cholesterol-lowering efficacy of these five main alkaloids. MAIN METHODS The cellular lipid and cholesterol accumulation and in HepG2 cells were evaluated by Oil Red O staining and HPLC analysis. LDL receptor, 3-Hydroxy-3-methylglutaryl CoA reductase (HMGCR) and cholesterol 7-alpha-hydroxylase (CYP7A1) that involving cholesterol metabolism in HepG2 cells were measured by qRT-PCR, western blot and immunofluorescence analysis. The serum profiles including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c), as well as TC and total bile acids (TBA) of feces in hypercholesterolemic hamsters were also measured. KEY FINDING As compared to single alkaloids, the combination of five main alkaloids (COM) reduced the lipid and cholesterol accumulation in HepG2 cells more effectively and performed an advantageous effect on controlling TC, TG, LDL-c and HDL-c in hypercholesterolemic hamsters. More effective reduction of TBA and TC levels in feces of hamsters were achieved after the administration of COM. These effects were derived from the up-regulation of LDL receptor and CYP7A1, as well as HMGCR downregulation. SIGNIFICANCE Our results demonstrated that COM showed a synergetic cholesterol-lowering efficacy, which was better than single alkaloids and it might be considered as a potential therapy for hypercholesterolemia.
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18
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Abstract
BACKGROUND Medication use is a potentially modifiable risk factor for falling; psychotropic and cardiovascular drugs have been indicated as main drug groups that increase fall risk. However, evidence is mainly based on studies that recorded falls retrospectively and/or did not determine medication use at the time of the fall. Therefore, we investigated the associations indicated in the literature between medication use and falls, using prospectively recorded falls and medication use determined at the time of the fall. METHODS Data from the B-PROOF (B-vitamins for the prevention of osteoporotic fractures) study were used, concerning community-dwelling elderly aged ≥65 years. We included 2,407 participants with pharmacy dispensing records. During the 2- to 3-year follow-up, participants recorded falls using a fall calendar. Cox proportional hazard models were applied, adjusting for potential confounders including age, sex, health status variables and concomitant medication use. RESULTS During follow-up, 1,147 participants experienced at least one fall. Users of anti-arrhythmic medication had an increased fall risk (hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.12-2.32) compared with non-users. Similarly, non-selective beta-blocker use was associated with an increased fall risk (HR 1.41 [95% CI 1.12-1.78]), while statin use was associated with a lower risk (HR 0.81 [95% CI 0.71-0.94]). Benzodiazepine use (HR 1.32 [95% CI 1.02-1.71]), and antidepressant use (HR 1.40 [95% CI 1.07-1.82]) were associated with an increased fall risk. Use of other cardiovascular and psychotropic medication was not associated with fall risk. CONCLUSION Our results strengthen the evidence for an increased fall risk in community-dwelling elderly during the use of anti-arrhythmics, non-selective beta-blockers, benzodiazepines, and antidepressant medication. Clinicians should prescribe these drugs cautiously and if possible choose safer alternatives for older patients.
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Lo-Ciganic WH, Perera S, Gray SL, Boudreau RM, Zgibor JC, Strotmeyer ES, Donohue JM, Bunker CH, Newman AB, Simonsick EM, Bauer DC, Satterfield S, Caserotti P, Harris T, Shorr RI, Hanlon JT. Statin use and decline in gait speed in community-dwelling older adults. J Am Geriatr Soc 2015; 63:124-9. [PMID: 25537649 PMCID: PMC4300263 DOI: 10.1111/jgs.13134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To examine the association between statin use and objectively assessed decline in gait speed in community-dwelling older adults. DESIGN Longitudinal cohort study. SETTING Health, Aging and Body Composition (Health ABC) Study. PARTICIPANTS Two thousand five participants aged 70-79 at baseline with medication and gait speed data at 1998-99, 1999-2000, 2001-02, and 2002-03. MEASUREMENTS The independent variables were any statin use and their standardized daily doses (low, moderate, high) and lipophilicity. The primary outcome measure was decline in gait speed of 0.1 m/s or more in the following year of statin use. Multivariable generalized estimating equations were used, adjusting for demographic characteristics, health-related behaviors, health status, and access to health care. RESULTS Statin use increased from 16.2% in 1998-99 to 25.6% in 2002-03. The overall proportions of those with decline in gait speed of 0.1 m/s or more increased from 22.2% in 1998 to 23.9% in 2003. Statin use was not associated with decline in gait speed of 0.1 m/s or more (adjusted odds ratio (AOR) = 0.90, 95% confidence interval (CI) = 0.77-1.06). Similar nonsignificant trends were also seen with the use of hydrophilic or lipophilic statins. Users of low-dose statins were found to have a 22% lower risk of decline in gait speed than nonusers (AOR = 0.78, 95% CI = 0.61-0.99), which was mainly driven by the results from 1999-2000 follow-up. CONCLUSION These results suggest that statin use did not increase decline in gait speed in community-dwelling older adults.
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Affiliation(s)
- Wei-Hsuan Lo-Ciganic
- Center for Pharmaceutical Policy and Prescribing, School of Health Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Subashan Perera
- Department of Medicine (Geriatrics), School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Shelly L. Gray
- School of Pharmacy, University of Washington, Seattle, WA
| | - Robert M. Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Janice C. Zgibor
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Elsa S. Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Julie M. Donohue
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Clareann H. Bunker
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Anne B. Newman
- Department of Medicine (Geriatrics), School of Medicine, University of Pittsburgh, Pittsburgh, PA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | | | - Douglas C. Bauer
- Division of General Medicine, School of Medicine, University of California, San Francisco, CA
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Paolo Caserotti
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark
| | - Tamara Harris
- Intramural Research Program, National Institute on Aging, Baltimore, MD
| | - Ronald I. Shorr
- North Florida/South Georgia Veterans Health System Geriatric Research Education and Clinical Center, Gainesville, FL
| | - Joseph T. Hanlon
- Center for Pharmaceutical Policy and Prescribing, School of Health Sciences, University of Pittsburgh, Pittsburgh, PA
- Department of Medicine (Geriatrics), School of Medicine, University of Pittsburgh, Pittsburgh, PA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
- Center for Health Equity Research and Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA
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The safety and anti-hypercholesterolemic effect of coptisine in Syrian golden hamsters. Lipids 2014; 50:185-94. [PMID: 25547428 DOI: 10.1007/s11745-014-3983-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
Abstract
Current work was conducted to evaluate the cholesterol-lowering effect of coptisine extracted from Rhizoma coptidis in Syrian golden hamsters. The safety results indicated that coptisine was a safe and low-toxic compound. Coptisine showed a beneficial effect in the abnormal serum lipid levels induced by a high-fat and high-cholesterol diet (HFHC): at a concentration of 70.05 mg/kg, coptisine significantly led to a decrease in total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-c) levels by 26.70, 15.38, and 22.22 %, respectively, and high-density lipoprotein cholesterol (HDL-c) was increased by 41.74 % in serum of hamsters (p < 0.01). In addition, total bile acid (TBA) levels in feces of hamsters were elevated after coptisine administration. Further investigation has suggested that the mRNA and protein expression of 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMGCR) in the liver of hamsters was down-regulated by high-dosage coptisine treatment (p < 0.05); mRNA and protein expression of low-density lipoprotein receptor (LDLR) and cholesterol 7α-hydroxylase (CYP7A1) were dramatically up-regulated by coptisine administration. The apical sodium-dependent bile salt transporter expression was down-regulated in the coptisine-treated animals, but showed no significant differences from the HFHC groups. Taken together, our results demonstrate that a high dosage of coptisine could inhibit cholesterol synthesis via suppressing the HMGCR expression and promoting the use and excretion of cholesterol via up-regulating LDLR and CYP7A1 expression. These findings suggest a critical role for coptisine in anti- hypercholesterolemia, and thus it needs to be considered as a potential natural cholesterol lowering agent.
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Wu H, He K, Wang Y, Xue D, Ning N, Zou Z, Ye X, Li X, Wang D, Pang J. The antihypercholesterolemic effect of jatrorrhizine isolated from Rhizoma Coptidis. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2014; 21:1373-1381. [PMID: 24894270 DOI: 10.1016/j.phymed.2014.05.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/04/2014] [Accepted: 05/10/2014] [Indexed: 06/03/2023]
Abstract
Current work was conducted to evaluate the safety and antihypercholesterolemic activity of jatrorrhizine extracted from Rhizoma Coptidis (RC) and its potential mechanism on regulating cholesterol metabolism. It was found that the LD50 of jatrorrhizine in mice was more than 5,500 mg/kg and there were no influences on clinical signs, organ weight changes, urinalysis and hematological parameters, gross necropsy and histological alterations in jatrorrhizine-treated rats during the 3-month period, compared to the control group. Jatrorrhizine showed a strong lipid-lowering effect in a dose-dependent manner. Oral administration of 70.05 mg/kg of jatrorrhizine on Mesocricetus auratus (Syrian golden hamsters) exhibited significant decrease in TC, TG, and LDL-c levels by 20%, 43%, and 19%, respectively, and increase in HDL-c and total bile acids (TBA) content in feces (p<0.01), compared to high-fat and high-cholesterol (HFHC) group. Besides, jatrorrhizine dose-dependently slowed the rate of weight gain. The results of qRT-PCR, western blotting and ELISA revealed that jatrorrhizine significantly up-regulated the mRNA and protein expression of LDLR and CYP7A1, but exhibited no significant effect on mRNA and protein expression of HMGR and ASBT in hamsters. In conclusion, jatrorrhizine was a safe and potential antihypercholesterolemic agent from RC which could improve the utilization and excretion of cholesterol by up-regulating the mRNA and protein expression of LDLR and CYP7A1.
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Affiliation(s)
- Hao Wu
- School of Life Sciences, Southwest University, Chongqing 400715, China
| | - Kai He
- School of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - YanZhi Wang
- School of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - DongFang Xue
- School of Life Sciences, Southwest University, Chongqing 400715, China
| | - Na Ning
- School of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Zongyao Zou
- School of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Xiaoli Ye
- School of Life Sciences, Southwest University, Chongqing 400715, China.
| | - Xuegang Li
- School of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China.
| | - DeZhen Wang
- School of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Jie Pang
- School of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
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Tsang RSM, Sachdev PS, Reppermund S, Kochan NA, Kang K, Crawford J, Wen W, Draper B, Trollor JN, Slavin MJ, Mather KA, Assareh A, Seeher KM, Brodaty H. Sydney Memory and Ageing Study: an epidemiological cohort study of brain ageing and dementia. Int Rev Psychiatry 2013; 25:711-25. [PMID: 24423224 DOI: 10.3109/09540261.2013.860890] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Non-demented community-dwelling older adults aged 70-90 years (n = 1,037) randomly recruited from the electoral roll completed neuropsychological and medical assessments over six years. The overall prevalence of mild cognitive impairment (MCI) at baseline was 36.7%. Risk factors for MCI include APOE ε4 allele carrier status, high homocysteine, heart disease, poor odour identification, low visual acuity and low mental activity, but notable age and sex differences were observed. Neuropsychiatric symptoms were rare; depression was the most common and was associated with cognitive impairment in at least one domain as well as subsequent dementia 2 years later. Poorer cognitively demanding functional abilities were associated with cognitive impairment. Biomarkers for cognitive impairment and decline were identified. Inflammatory markers and plasma apolipoprotein levels were associated with poorer performance in the attention/processing speed domain. Measures of white matter lesions, white matter integrity, sulcal morphology and tractography were identified as novel biomarkers of early cognitive decline. Stronger deactivation in the posteromedial cortex with increasing memory load on functional MRI predicted future decline. Compared to previous reports, our prevalence rates of MCI were higher but rates of progression to dementia and reversion to normal were similar, as were risk factors for progression to dementia.
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Affiliation(s)
- Ruby S M Tsang
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales , Sydney, NSW , Australia
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