The aim of the investigation was twofold: to study the effect of
lovastatin, a potent inhibitor of 3-hydroxy-3-methylglutaryl
coenzyme A reductase, alone and in combination with other
lipid lowering drugs in an open 48 week single centre study, and to study if
lipid lowering drugs influence adherence to diet in adult patients with
familial hypercholesterolemia.
Lovastatin monotherapy (80 mg daily) for 12 weeks reduced serum
cholesterol, LDL-
cholesterol and
triglycerides levels by 36%, 44% and 24% respectively.
HDL-cholesterol level was increased by 12%. The addition of 16 g
cholestyramine daily further increased the reduction of total
cholesterol and
LDL-cholesterol levels by 17% and 24% respectively. Addition of 1 g
probucol daily decreased total
cholesterol, LDL-
cholesterol and
HDL-cholesterol levels by 9%, 5% and 27% respectively. Addition of omega-3-fatty
acids (3.6 g daily) reduced total
cholesterol, LDL-
cholesterol and
triglycerides levels by 10%, 12% and 20% respectively. Administration of potent
lipid lowering agents did not influence adherence to a diet with a mean daily fat energy of 21% (CI: 20-22),
cholesterol of 177 mg (CI: 157-196) and P/S ratio of 0.75 (CI: 0.66-0.84). A significant increase in liver
enzymes was recorded in only one patient. One patient was withdrawn from the study because of
myositis.