A pilot study on intensive lipid lowering--a new approach to cardiac rehabilitation.

The deleterious effects of raised plasma lipids on the progression of coronary artery disease has been well established. Recent research data suggests that intensive lipid lowering represents a new approach to Cardiac Rehabilitation. There was a total of twenty-four participants with twenty-one (87.5%) males and three (12.5%) females. There were seventeen Chinese (70.8%), six Indians (25%) and one Malay (4.2%). Their ages ranged from group forty to forty-nine, five participants (20%); fifty to fifty-nine, twelve participants (50%); sixty to sixty-nine, six participants (25%) and seventy to seventy-nine, one participant (5%). In this study, twelve individuals were treated with Cholestyramine, seven by Gemfibrozil, four by Clofibrate and three by Bezafibrate. The duration of antilipid treatment ranged from two to eighteen months (mean eight months). Side effects were reported in twelve patients (50%) on Cholestyramine who complained of constipation while one (4%) on Bezafibrate had abnormal liver function tests (raised SGOT and SGPT). All patients had been on an exercise and diet control program for one year which they were enrolled in an intensive lipid-lowering protocol. The pre and post treatment lipid profiles with lipid-lowering agents showed 18% reduction for Triglycerides, 15% reduction for Total Cholesterol, 5% increase for HDL-Cholesterol, 19% decrease in LDL Cholesterol, 19% decrease in Total Cholesterol: HDL ratios. The initial results suggest that an intensive lipid-lowering strategy in a Cardiac Rehabilitation Program appears to have a beneficial effect on lipid profiles and represents an expanded approach to lipid management involving exercise, nutrition and pharmacological intervention.