Portal de Periódicos da CAPES

Effectiveness of high doses of simvastatin as monotherapy in mixed hyperlipidemia

2001; Elsevier BV; Volume: 87; Issue: 2 Linguagem: Inglês

10.1016/s0002-9149(00)01327-8

1879-1913

Michael Miller, Christina Dolinar, William C. Cromwell, James D. Otvos,

Health Systems, Economic Evaluations, Quality of Life

Mixed hyperlipidemia is a heterogenous disorder characterized by elevated levels of total cholesterol, low-density lipoprotein (LDL) cholesterol and triglycerides, and reduced levels of high-density lipoprotein (HDL) cholesterol. It represents a subgroup of familial combined hyperlipidemia, the most common lipoprotein phenotype identified in young survivors of myocardial infarction. 1 Goldstein J.L Schrott H.G Hazzard W.R Bierman E.L Motulsky A.G Hyperlipidemia in coronary heart disease. II Genetic analysis of lipid levels in 176 families and delineation of a new inherited disorder, combined hyperlipidemia. J Clin Invest. 1973; 52: 1544-1568 Crossref PubMed Scopus (1089) Google Scholar Both genetic and environmental (e.g., insulin resistance) interactions contribute to the mixed hyperlipidemic syndrome. 2 de Graaf J Stalenhoef A.F.H Defects of lipoprotein metabolism in familial combined hyperlipidemia. Curr Opin Lipidol. 1998; 9: 189-196 Crossref PubMed Scopus (73) Google Scholar It has been suggested that if monotherapy were a consideration, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (e.g., statins) may be an appropriate initial therapy because of their salutory impact on all lipid and lipoprotein parameters. 3 Schonfeld G Aguilar-Salina C Elias N Role of 3-hydroxy-3methylglutaryl coenzyme A reductase inhibitors ("statins") in familial combined hyperlipidemia. Am J Cardiol. 1998; 81: 43B-46B Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar Recently, the highest dose of simvastatin (e.g., 80 mg) significantly reduced total cholesterol and LDL cholesterol while improving HDL cholesterol in hypercholesterolemic subjects. 4 Crouse J.R Frohlich J Ose L Mercuri M Tobert J.A Effects of high doses of simvastatin and atorvastatin on high-density lipoprotein cholesterol and apolipoprotein A-I. Am J Cardiol. 1999; 83: 76-77 Abstract Full Text Full Text PDF Scopus (131) Google Scholar This study evaluates high doses of simvastatin (40 and 80 mg) on lipids, lipoproteins, and lipoprotein subclasses using proton nuclear magnetic resonance spectroscopy. The results demonstrate that high doses of simvastatin are efficacious with mixed hyperlipidemia and that single agent therapy may be useful for the management of dyslipidemia in this high-risk subgroup.