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document
[ Simvastatin versus gemfibrozil in the treatment of primary hypercholesterolemia in hypertensive patients treated with hydrochlorothiazide ] . Recent pharmacological studies confirmed the role of hypercholesterolemia in the pathogenesis of coronary atherosclerosis . A 10 % reduction in cholesterol levels can reduce the risk of coronary heart disease by 15 % . However many hypercholesterolemic patients often suffer from arterial hypertension and drugs such as thiazide diuretics cause an imbalance in lipid metabolism . The efficacy and the tolerability of simvastatin ( a inhibitor of HGM-CoA reductase ) with that of gemfibrozil ( a fibric acid derivative , which can reduce the VLDL level ) were compared in a placebo-controlled study in 2 groups of patients with primary hypercholesterolemia and mild-to-moderate essential hypertension treated with hydrochlorothiazide . After 10 weeks standard hypolipidemic diet and hydrochlorothiazide ( 25 mg od ) therapy , 30 patients whose cholesterol levels were still greater than or equal to 250 mg/100 ml and whose diastolic blood pressure was less than 95 mmHg were randomized to one of the following treatments : simvastatin , 20 mg od , gemfibrozil , 600 mg bid or placebo , while continuing dietetic and diuretic treatment . After 24 weeks treatment , simvastatin induced a 37 % reduction in cholesterol plasma levels , a 9 % increase of HDL and a 16 % reduction of LDL . APO-A1 showed a 4 % increase , while APO-B showed a 3 % reduction . Gemfibrozil induced a 20 % reduction in plasma triglycerides and a 13 % decrease in plasma cholesterol , with a significant 19 % increase in HDL and a 11 % reduction in LDL . No significant variations in any of the lipid parameters monitored were observed in the placebo group . Treatment with simvastatin or gemfibrozil in hypertensive patients in hydrochlorothiazide monotherapy can reduce total cholesterol and LDL-cholesterol plasma levels , while significantly increasing HDL plasma levels compared to placebo . Simvastatin , however , resulted more efficient than gemfibrozil on total cholesterol or cholesterol fractions .
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Intervention_Pharmacological
[ Simvastatin versus gemfibrozil
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Intervention_Pharmacological
hydrochlorothiazide ]
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Intervention_Pharmacological
thiazide diuretics
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Intervention_Pharmacological
simvastatin
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Intervention_Pharmacological
gemfibrozil
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
standard hypolipidemic diet
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Intervention_Pharmacological
hydrochlorothiazide
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Intervention_Pharmacological
simvastatin
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Intervention_Pharmacological
gemfibrozil
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Intervention_Control
or placebo
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Intervention_Pharmacological
simvastatin
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Intervention_Pharmacological
Gemfibrozil
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Intervention_Control
placebo
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Intervention_Pharmacological
simvastatin
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Intervention_Pharmacological
gemfibrozil
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Intervention_Pharmacological
hydrochlorothiazide
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Intervention_Pharmacological
Simvastatin
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Intervention_Pharmacological
gemfibrozil
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Outcome_Other
efficacy and the tolerability
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Outcome_Physical
cholesterol levels
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Outcome_Physical
diastolic blood
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Outcome_Physical
cholesterol plasma levels
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Outcome_Physical
HDL
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Outcome_Physical
LDL . APO-A1
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Outcome_Physical
plasma triglycerides
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Outcome_Physical
plasma cholesterol
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Outcome_Physical
HDL
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Outcome_Physical
LDL .
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Outcome_Physical
total cholesterol and LDL-cholesterol plasma levels
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Outcome_Physical
HDL plasma levels
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Outcome_Physical
total cholesterol or cholesterol fractions .
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Participant_Condition
primary hypercholesterolemia in hypertensive patients treated with hydrochlorothiazide ]
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Participant_Condition
mild-to-moderate essential hypertension
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Participant_Sample-size
30