Analysis of Methods for Normalizing Lipid Profile and Blood Pressure in Patients with Chronic Coronary Syndromes

Introduction. Despite advancements in modern cardiology, cardiovascular diseases remain the leading cause of death in the Russian Federation and worldwide. A key predictor of these diseases is hyperlipidemia. Current treatment strategies involve increasingly aggressive lipid-lowering therapy to achieve target levels of low-density lipoprotein cholesterol and triglycerides. The aim of this study is a comprehensive investigation of the major risk factors for the development of ischemic heart disease and an analysis of the drug therapy used in patients with chronic coronary syndromes. Materials and methods. We studied 85 outpatient medical records of patients with established diagnoses of “Stable exertional angina” and “Post-infarction cardiosclerosis” aged between 40 and 85 years (the mean age of participants was 65.27 (±1.02) years; 49 men and 36 women). Patients with acute coronary syndromes were not included in the study. The study was conducted through a retrospective analysis of outpatient medical records. Results. Studying the processes of plaque formation in blood vessels (atherogenesis) and the influence of various risk factors (e.g., smoking, obesity, diabetes, arterial hypertension) helps to better understand the pathophysiology of the disease and develop effective preventive measures. The analysis revealed insufficient efficacy of the ongoing statin therapy in this patient group, as the target levels of low-density lipoprotein cholesterol were not achieved. Modern treatment methods include lifestyle modifications, dietary therapy, and the use of pharmacological agents (statins, ezetimibe, bile acid sequestrants, fibrates). However, the effectiveness of these approaches is limited, particularly in severe cases of familial hypercholesterolemia. Therefore, further research is necessary to develop new therapeutic strategies, such as PCSK9-inhibiting monoclonal antibodies and drugs that reduce cholesterol synthesis in the liver. The development of personalized treatment approaches based on individual patient characteristics (genotype, phenotype, comorbidities) will improve therapy efficacy and reduce drug side effects. Discussion and conclusion. Analysis of retrospective data obtained from outpatient records revealed the treatment strategies employing lipid-lowering drugs (atorvastatin, rosuvastatin, simvastatin) used in the patients. Out of 85 patients, 82 (97.64%) received statins. Only 3 patients (3.52%) achieved the target levels of low-density lipoprotein cholesterol. The conducted retrospective analysis demonstrated the low clinical efficacy of the prescribed statin therapy. The prospects for developing new drugs to treat hypercholesterolemia are focused around several key areas: PCSK9 inhibitors (proprotein convertase subtilisin/kexin type 9 inhibitors), ASGR1 modulators (asialoglycoprotein receptor 1 modulators), statin derivatives, selective cholesterol synthesis inhibitors, and therapies using the “genomic scissors” technique (e.g., CRISPR-based approaches). The presented research perspectives create the prerequisites for developing an individualized management algorithm for each patient. This approach has the potential to significantly minimize the likelihood of adverse drug reactions and optimize the clinical outcomes of the treatment process.