TY - JOUR
T1 - Lipoprotein responses to treatment with lovastatin, gemfibrozil, and nicotinic acid in normolipidemic patients with hypoalphalipoproteinemia
AU - Vega, Gloria L
AU - Grundy, Scott M
N1 - Funding Information:
AcceptedforpublicationJuly 15, 1993. This work was supported by the Department of Vet¬ eransAffairs;grantsHL-29252 andMO-IRR00663from theNationalInstitutes ofHealth, Bethesda, Md; Merck & CoInc,WestPoint,NewPa;anunrestrictedtheSouthwesterngrantfromBristol-Medi¬ MyersSquibb, Brunswick,NJ; calFoundation,Dallas,Tex;andtheMossHeartFoun¬ dation,Dallas. Weexpressourappreciationfortheexcellenttech¬ nicalassistanceofHahnNugyenTran,HahnTron,Gwin- dolyn Nugyen Tron, and Ivan Yuhanni. The assistanceof Marjorie Whelan, RN, and the clinical staffs of the meta¬ bolic unit attheVeterans Affairs Medical Center and the GeneralClinicalResearchCenteratParklandMemorial Hospital, Dallas, isgreatly appreciated. We also thank Bev¬ erlyAdams, program analyst, oftheGeneral Clinical Re-
Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1994/1/10
Y1 - 1994/1/10
N2 - Background: The lipoprotein responses to conventional lipid-modifying drugs have not been adequately evaluated in normolipidemic patients with hypoalphalipoproteinemia (low levels of high-density lipoproteins). The purpose of this study was to compare responses to lovastatin, gemfibrozil, and nicotinic acid in such patients. Methods: The first phase of the study compared lipoprotein responses to lovastatin and gemfibrozil in 61 middle- aged men with low levels of high-density lipoproteins. In the second phase, 37 patients agreed to take nicotinic acid; 27 patients finished this phase at a dose of 4.5 g/d. Nicotinic acid results were compared with those with lovastatin and gemfibrozil in the same patients. Results: In the first phase, both drugs effectively lowered triglyceride levels. Gemfibrozil therapy increased high-density lipoprotein cholesterol levels by 10% and lovastatin by 6%, but lovastatin was much more effective for reducing low-density lipoprotein levels. Nicotinic acid did not significantly lower low-density lipoprotein levels in the second phase, but it raised high-density lipoprotein levels by 30%. Conclusions: Gemfibrozil therapy produced the least favorable response of the three drugs. Lovastatin markedly lowered low- density lipoprotein levels but only modestly raised levels of high-density lipoprotein, whereas nicotinic acid had the opposite effect. Consequently, the latter two drugs similarly reduced low-density lipoprotein-high-density lipoprotein ratios, although these effects were obtained in different ways. Between these two drugs, lovastatin therapy was more likely to reduce low- density lipoprotein cholesterol levels to below 2.6 mmol/L (100 mg/dL), and in view of recent recommendations, it may be preferable to nicotinic acid for many normolipidemic patients with established coronary heart disease.
AB - Background: The lipoprotein responses to conventional lipid-modifying drugs have not been adequately evaluated in normolipidemic patients with hypoalphalipoproteinemia (low levels of high-density lipoproteins). The purpose of this study was to compare responses to lovastatin, gemfibrozil, and nicotinic acid in such patients. Methods: The first phase of the study compared lipoprotein responses to lovastatin and gemfibrozil in 61 middle- aged men with low levels of high-density lipoproteins. In the second phase, 37 patients agreed to take nicotinic acid; 27 patients finished this phase at a dose of 4.5 g/d. Nicotinic acid results were compared with those with lovastatin and gemfibrozil in the same patients. Results: In the first phase, both drugs effectively lowered triglyceride levels. Gemfibrozil therapy increased high-density lipoprotein cholesterol levels by 10% and lovastatin by 6%, but lovastatin was much more effective for reducing low-density lipoprotein levels. Nicotinic acid did not significantly lower low-density lipoprotein levels in the second phase, but it raised high-density lipoprotein levels by 30%. Conclusions: Gemfibrozil therapy produced the least favorable response of the three drugs. Lovastatin markedly lowered low- density lipoprotein levels but only modestly raised levels of high-density lipoprotein, whereas nicotinic acid had the opposite effect. Consequently, the latter two drugs similarly reduced low-density lipoprotein-high-density lipoprotein ratios, although these effects were obtained in different ways. Between these two drugs, lovastatin therapy was more likely to reduce low- density lipoprotein cholesterol levels to below 2.6 mmol/L (100 mg/dL), and in view of recent recommendations, it may be preferable to nicotinic acid for many normolipidemic patients with established coronary heart disease.
UR - http://www.scopus.com/inward/record.url?scp=0028082368&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028082368&partnerID=8YFLogxK
U2 - 10.1001/archinte.154.1.73
DO - 10.1001/archinte.154.1.73
M3 - Article
C2 - 8267492
AN - SCOPUS:0028082368
SN - 0003-9926
VL - 154
SP - 73
EP - 82
JO - Archives of Internal Medicine
JF - Archives of Internal Medicine
IS - 1
ER -