Slide 1New Cholesterol Treatment Guidelines: AHA/ ACCMuscle damage following the Boston Marathon Parker, et al 2012Slide 4Slide 5Slide 6Slide 7What is citrate synthase?So…Overall Summary: Exercise and LipidsEvidence for the effect of exercise training on lipidsLecture 3New Cholesterol Treatment Guidelines: AHA/ ACC4 groups of people who should be on statins1) People without cardiovascular disease who are 40 to 75 years old and have a 7.5 percent or higher risk for having a heart attack or stroke within 10 years.2) People with a history of a cardiovascular event (heart attack, stroke, stable or unstable angina, peripheral artery disease, transient ischemic attack, or coronary or other arterial revascularization).3) People 21 and older who have a very high level of bad cholesterol (190 mg/dL or higher).4) People with Type 1 or Type 2 diabetes who are 40 to 75 years old.Good things: improved preventionreduce costs of CVD (direct and potentially indirect)decrease Bad things: increased costs with more meds dispensedconsequence for PAGood things: improved preventionreduce costs of CVD (direct and potentially indirect)decrease Bad things: increased costs with more meds dispensedconsequence for PAMuscle damage following the Boston MarathonParker, et al 2012Muscle damage following the Boston MarathonParker, et al 2012Simvistatin Impairs Exercise Training Adaptations (Mikus, et al 2013) 12 weeks endurance exercise training.Simvistatin Impairs Exercise Training Adaptations (Mikus, et al 2013)Mikus, et al 2013. Simvistatin Impairs Exercise Training Adaptations. J. Am. Coll Cardiol.Simvistatin Impairs Exercise Training Adaptations (Mikus, et al 2013)Mikus, et al 2013. Simvistatin Impairs Exercise Training Adaptations. J. Am. Coll Cardiol.What is citrate synthase?•Necessary for Krebs cycle (AKA Citric Acid cycle or TCA cycle)•Increases with endurance exercise trainingSo…•Patients on statins may have more muscle pain/damage•Individuals on statins need to be careful with exercise (particularly strenuous exercise)•Should be aware that statin medications may attenuate their capacity to respond to exercise training (increase VO2max and energy metabolism pathway adaptations)Overall Summary: Exercise and Lipids•Most studies show a decrease in TG with exercise training (______ mg/dL)•Most studies show an increase in HDL with exercise training (______ mg/dL)•Need _____ intensity, may be a better effect in _____•While not all studies show a decrease in LDL with exercise training, there appear to be significant changes in _________________–Less
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