Suplemento

Las enfermedades cardiovasculares constituyen la primera causa de morbilidad y mortalidad en el mundo, tanto en los países desarrollados como en los que están en vías de desarrollo. La dislipidemia –asociada a la disfunción endotelial- y a los fenómenos inflamatorios vasculares, son los procesos iniciales en la patogénesis de la enfermedad arterial arterioesclerótica. Es evidente la asociación directa y lineal entre los niveles de colesterol de baja densidad y el riesgo de enfermedad arterial arterioesclerótica, al igual que el efecto benéfico de la intervención con fármacos que actúan en diferentes niveles (estatinas, ezetimibe, fibratos, anticuerpos monoclonales contra la PCSK9, entre otros).

Por su parte, la hipertrigliceridemia, y los niveles bajos de colesterol de alta densidad, al igual que otros parámetros como el colesterol no-HDL y otras lipoproteínas, también juegan un papel importante en la etiopatogenia de la enfermedad arterioesclerótica, y existe evidencia en favor de la modificación de dichos parámetros. Los nuevos fármacos han cambiado de forma sustancial los desenlaces cardiovasculares en individuos con alto riesgo cardiovascular, y en individuos con intolerancia a las estatinas. Las diferentes guías internacionales para el manejo de la dislipidemia comparten muchos aspectos respecto al manejo farmacológico y no farmacológico.

Sin embargo, existen algunas diferencias importantes entre ellas, incluso en la forma de abordar individuos con situaciones especiales de dislipidemia (embarazo, enfermedad renal crónica, entre otras).

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Cardiovascular
cLDL
estatinas
fibratos
riesgo
dieta
ezetimibe
PCSK9