We tested the possibility that simvastatin, a competitive inhibitor of HMG-CoA reductase related to mevinolin, might alter cholesterol saturation of gallbladder bile. Ten patients with Type IIa or IIb hypercholesterolemia underwent bile sampling before, and again after, treatment with 20 or 40 mg per day simvastatin for 7 to 13 weeks. Mean cholesterol saturation index of gallbladder bile fell from 1.01 to 0.77 during simvastatin treatment (p less than 0.01). This finding strongly suggests that treatment with HMG-CoA reductase inhibitors will not predispose to development of cholesterol gallstones. Indeed, it raises the possibility that such inhibitors might have a future role to play in treatment of gallstones.

Adult↗

PubMedDate not supplied

Inhibition of histamine-stimulated increases in heart rate in man with the H2-histamine receptor antagonist cimetidine.

The influence of an H2-histamine receptor antagonist, cimetidine, on histamine-induced changes in heart rate and blood pressure was examined in a randomized double-blind study in six fasted male subjects. The intravenous infusion of histamine (10 microgram/min) for 20 minutes caused an immediate and sustained increase in heart rate (26 per cent and a transient fall in mean arterial blood pressure (10 per cent). Cimetidine pretreatment (300 mg intravenously) inhibited histamine-elevated heart rate by 75 per cent (P less than 0.05) and histamine-decreased blood pressure by 54 per cent (P less than 0.05). Cimetidine by itself did not cause significant changes in heart rate or blood pressure. These results illustrate that H2-histamine receptor antagonists significantly inhibit histamine-induced increases in heart rate in man and support the potential use of cimetidine in certain cases of tachyarrhythmia.

Adult↗

PubMedDate not supplied

Blood lipid effects of antihypertensive therapy: a double-blind comparison of the effects of methyldopa and propranolol.

Thirty-two middle-aged men with essential hypertension completed a double-blind randomly allocated comparison of the effects of methyldopa versus propranolol on blood lipid levels. After a four-week period on a placebo for each drug, subjects were titrated for the next six weeks with either methyldopa from 500 to 2000 mg/day or propranolol from 80 to 320 mg/day plus a placebo for the other drug until supine diastolic blood pressure was below 90 mm Hg or the ceiling dose was reached. Subjects were then maintained on the achieved drug dose for an additional six weeks and finally switched back to a placebo for each drug for four more weeks. Blood lipid levels were measured twice during each study period and the values averaged and compared. Neither drug significantly affected levels of total plasma cholesterol. However, both drugs reduced high-density lipoprotein (HDL) cholesterol levels about 10 per cent and increased the total cholesterol to HDL cholesterol ratio. In addition, propranolol significantly increased plasma triglyceride levels (28.3 per cent). The changes in lipid levels were not dose related. Whether or not these blood lipid changes persist and their possible clinical implication during prolonged therapy remain to be elucidated.

Aged↗

PubMedDate not supplied

Treatment of type III hyperlipoproteinemia with four different treatment regimens.

The efficacy of clofibrate (CPIB) and nicotinic acid (NA) in the treatment of type III hyperlipoproteinemia was evaluated in 5 male subjects in a randomized cross-over study with clofibrate 1 g b.i.d. and NA 3 g/day (given either b.i.d. or t.i.d.). Following a baseline period of 6 weeks, each drug was given for 12 weeks with samples for lipid and lipoprotein determinations obtained at 6, 9, and 12 weeks. Both clofibrate and NA resulted in a significant reduction from baseline of total cholesterol (23% and 28%), VLDL cholesterol (49% and 56%), total triglycerides (40% and 43%), and VLDL triglycerides (46% and 48%), as well as a significant increase in HDL cholesterol (22% and 28%) and HDL/LDL ratio (31% and 62%). The HDL/LDL ratio was higher on NA than clofibrate (0.47 +/- 0.19 vs. 0.38 +/- 0.09, P less than 0.05). Four subjects were continued in the study and treated sequentially with NA 3.0 g/day (alternate to the previous schedule) and gemfibrozil 1.2 g/d in divided doses. Each of the 4 regimens resulted in a significant change from baseline of each of the measured lipid and lipoprotein determinations except LDL cholesterol. Comparison among the treatment regimens revealed no differences except for significantly higher HDL cholesterol and HDL/LDL ratio with NA given t.i.d.

Adult↗

PubMedDate not supplied

Prescription writing by generic name and drug cost.

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Costs and Cost Analysis↗

PubMedDate not supplied

Physiological markers of smoking and their relation to coronary heart disease. The Lipid Research Clinics Coronary Primary Prevention Trial.

Several physiological variables which have previously been found to be associated with extent of cigarette smoking were investigated in a population selected to be free of existing coronary heart disease yet having high circulating cholesterol levels. Of these variables, white blood cell count had the strongest association with the extent of smoking. The addition of hematocrit and heart rate to white blood cell count strengthened the association. Given these three variables, however, other physiological variables had a minor effect on the association. Finally, the combination of these three physiological variables was more strongly predictive of subsequent coronary heart disease than was self-reported smoking level.

Coronary Disease↗

PubMedDate not supplied

Which patients need aggressive lipid-altering therapy?

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Cholesterol, HDL↗

PubMedDate not supplied

Patient perceptions about the influence of cholesterol on heart disease.

National surveys have shown that adults need to known more about their own blood cholesterol levels and about specific methods for lowering blood cholesterol. We examine patient perceptions of cholesterol and heart disease after their participation in a cholesterol management program designed for the primary care setting. We counseled 221 patients and successfully interviewed 179 by telephone four weeks after their initial dietary counseling visit. Nine of 10 patients could report their cholesterol level, and 98% of patients could appropriately label it as borderline-high or high-risk. Ninety-seven percent of the patients could give one valid reason why cholesterol was important to their health. Many patients knew specific dietary recommendations from counselors. Patients positively reviewed counseling and the cholesterol management program. A large percentage of patients had already made changes in diet and eating habits at the time of the interview. Total cholesterol measurements showed a mean reduction of 8.5% postcounseling.

Adult↗