The major cause of death in the Western world is some form of vascular disease; and principal among these forms is atherosclerotic heart disease (ASHD). Although much is known about the etiology and treatment of ASHD, there is, as yet, no specific means of prognosis of an impending coronary episode. There are, however, several indications of susceptibility to coronary disease, generally known as risk factors, the foremost of which is hyperlipidemia. Hyperlipidemia is more commonly designated as hypercholesteremia or triglyceridemia, depending upon which moiety is elevated, but since lipids are transported in the blood as members of a lipoprotein complex, the most descriptive general term would be hyperlipoproteinemia. This volume represents an effort to elucidate the origins and metabolic behavior of lipoproteins and their components, to describe aspects of the morphology, biochemistry and experimental induction of ASHD, and to describe modalities of treatment. The contributions to this book include descriptions of cholesterol synthesis and metabolism, as well as the metabolism of bile acids, the principal products of cholesterol metabolism. There are also chapters on the mechanisms of hyperlipidemia and on lipoprotein metabolism. The induction of experimental atherosclerosis and the aortic structural changes caused by this disease are discussed.

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1 Cholesterol Biosynthesis in vitro.- I. Cell-Free Homogenates.- II. Microsomal and Soluble Enzymes; Squalene and Sterol Carrier Protein Applications.- III. Preparations and Activity Assays.- References.- 2 Cholesterol Metabolism in Man.- I. Introduction.- II. Distribution of Cholesterol in the Body.- III. Functions of Cholesterol.- IV. Synthesis of Cholesterol.- V. Absorption of Dietary Cholesterol.- VI. Catabolism of Cholesterol and Its Losses from the Body Pools.- VII. Plasma Cholesterol.- VIII. Relationship of Cholesterol in Plasma and Tissue Pools.- IX. Homeostasis of Plasma Cholesterol.- X. Plasma Cholesterol Esters.- XI. Proposed Model for Cholesterol Metabolism in Man.- XII. Cholesterol Metabolism in Hyperlipoproteinemias.- References.- 3 Bile Acid Metabolism.- I. Introduction.- II. Enterohepatic Circulation.- III. Different Parameters of Bile Acid Metabolism.- IV. Regulation of Cholesterol Catabolism via Bile Acids.- V. Physiological Factors Influencing Bile Acid Metabolism.- VI. Effects of Hormones on Bile Acids.- VII. Hyperlipidaemia.- References.- 4 Mechanisms of Hyperlipidemia.- I. Introduction.- II. Normal Levels of Plasma Triglycerides and Cholesterol.- III. The Plasma Lipoprotein Spectrum.- IV. The Metabolism of Constituents of Plasma Lipoproteins.- V. Classification of Hyperlipidemias.- References.- 5 Lipoproteins and Lipoprotein Metabolism.- I. Structure and Functions of Lipoproteins.- II. Synthesis of Lipoproteins.- III. Lipoprotein Metabolism.- IV. The Hyperlipoproteinemias.- V. Treatment of Hyperpoproteinemia.- References.- 6 Animal Models for Atherosclerosis Research.- I. Rabbit.- II. Rat.- III. Chicken.- IV. Dog.- V. Pigeons.- VI. Swine.- VII. Primates.- References.- 7 Lipoprotein Formation in the Liver Cell (Ultrastructural and Functional AspectsRelevant to Hypolipidemic Action).- I. Introduction.- II. The Concept of Membrane Flow and Its Relevance to Secretion.- III. Formation and Secretion of Lipoproteins.- IV. Regulation of Lipoprotein Secretion.- V. Concluding Remarks.- References.- 8 Vascular Metabolism, Vascular Enzymes, and the Effect of Drugs.- I. Notes on Vascular Metabolism.- II. Vascular Enzyme Studies.- III. The Effect of Drugs.- Concluding Remarks.- Abbreviations.- References.- 9 Hypolipidemic Agents.- I. Introduction.- II. The Coronary Drug Project.- III. Nicotinic Acid and Analogs.- IV. Pyrazoles and Isoxazoles.- V. Diethyl Chelidonate.- VI. The Role of the Second Messenger in Lipolysis.- VII. Catecholamines, Adrenergic Blocking Agents.- VIII. Miscellaneous Inhibitors of Lipolysis.- IX. The Prostaglandins.- X. Thyroid Hormones.- XI. Estrogens, Progestagens, Anabolic, and Androgenic Compounds.- XII. Substituted Phenyl- and Phenyloxy-acetic Acids.- XIII. Hepatic Action of Clofibrate and Its Analogs.- XIV. Extrahepatic Enzymes Influenced by Clofibrate.- XV. Potential Antiatherosclerotic Effect of Clofibrate.- XVI. Derivatives of Dialkylaminoethanol.- XVII. Unsaturated Fatty Acids.- XVIII. Compounds Containing Sulfur.- XIX. Indole-2-Carboxylic Acids.- XX. Hydroxylamine Derivatives.- XXI. Pyridinolcarbamate.- XXII. Eritadenine.- XXIII. Miscellaneous Compounds.- XXIV. Cholestyramine.- XXV. Neomycin.- XXVI. Rifampin.- XXVII. Concluding Remarks.- References.- 10 The Rationale for Hypolipemic Therapy.- Cholesterol Lowering by Diet.- Conclusions from the Dietary Trials.- Cholesterol Lowering with Clofibrate.- Extrapolations between Different Lipid Lowering Techniques.- Summary of Opinions.- Conclusions.- References.- Author Index.