June 1990

Management of Primary Mixed Hyperlipidemia With Lovastatin

Author Affiliations

From the Center for Human Nutrition (Drs Vega and Grundy), Departments of Clinical Nutrition (Drs Vega and Grundy), Internal Medicine (Dr Grundy), and Biochemistry (Dr Grundy), University of Texas Southwestern Medical Center at Dallas, and Veterans Administration Medical Center (Dr Grundy), Dallas.

Arch Intern Med. 1990;150(6):1313-1319. doi:10.1001/archinte.1990.00390180119022

• Many patients with high levels of serum total cholesterol have a concomitant elevation of serum triglyceride levels and thus have mixed hyperlipidemia. In this study, 13 patients with mixed hyperlipidemia were treated with the cholesterol-lowering drug lovastatin to determine its effectiveness. In 9 of these patients, lovastatin therapy used alone was compared with the drug combination of lovastatin and gemfibrozil. In the 13 patients, lovastatin therapy produced a 31% reduction in total cholesterol level and a 32% decrease in triglyceride levels compared with placebo. It lowered very-low-density plus intermediate-density lipoprotein cholesterol levels by 40%, low-density lipoprotein cholesterol levels by 36%, and total apolipoprotein B levels by 28%. Concentrations of high-density lipoprotein cholesterol and apolipoprotein A-I were unchanged, but total cholesterol (and low-density lipoprotein cholesterol)/high-density lipoprotein cholesterol ratios were markedly reduced. Compared with lovastatin alone, lovastatin plus gemfibrozil produced greater decreases in very-low-density plus intermediate-density lipoprotein cholesterol levels and an increase in high-density lipoprotein cholesterol levels, but, in view of the higher risk for severe myopathy with this combination, lovastatin used alone may be adequate therapy for many patients with mixed hyperlipidemia.

(Arch Intern Med. 1990;150:1313-1319)