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February 19, 1992, Vol 267, No. 7 >
ARTICLE | February 19, 1992

Secondary Dyslipidemia: Title and subTitle BreakInadvertent Effects of Drugs in Clinical Practice FREE

Yaakov Henkin, MD; Jackson A. Como, PharmD; Albert Oberman, MD
[+] Author Affiliations

Reprint requests to Division of General and Preventive Medicine, University of Alabama at Birmingham, UAB Station, Medical Education Bldg, Room 621, Birmingham, AL 35294 (Dr Oberman).


JAMA. 1992;267(7):961-968. doi:10.1001/jama.1992.03480070077035
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References

Objective.  —To examine the available literature on commonly prescribed drugs and their effects on blood lipid and lipoprotein levels.

Data Sources.  —The review was based on searches of English-language articles from 1975 to 1990 by Medlars II and MEDLINE programs, the Index Medicus for 1980 to 1990, and references from identified articles. Relevant journals published within the last 6 months were also examined.

Study Selection.  —More than 500 articles were identified for inclusion. Articles were selected on the basis of appropriateness of design to demonstrate significant results, determined by consensus when necessary.

Data Extraction.  —Studies were classified according to type (observational or interventional), length of follow-up, and type of controls. Quanitative analysis of lipid, lipoprotein, and apoprotein changes induced by drugs was computed as the percentage of change observed during the course of the study (interventional) or compared with the controls at a given time (observational).

Data Synthesis.  —Steroid hormones that have strong progestogenic and androgenic properties, retinoids, cyclosporine A, and phenothiazines are potentially atherogenic. Steroid hormones with dominant estrogenic properties, several anticonvulsants, biguanides, high-dose ketoconazole, and aminosalicylic acid are potentially antiatherogenic. Corticosteroids appear to elevate all the lipoprotein cholesterol levels. Oral estrogens, retinoids, and corticosteroids also can elevate triglyceride levels. Other drugs with questionable effects on lipoprotein metabolism are reviewed.

Conclusion.  —Although the long-term implications of drug-induced lipoprotein changes are still undefined, physicians need to consider these effects in clinical practice.(JAMA. 1992;267:961-968)

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

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To understand the clinical management of acute heart failure syndromes.
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