Pravastatin vs gemfibrozil in the treatment of primary hypercholesterolemia: the Italian Multicenter Pravastatin Study I

There is a link between low-density-lipoprotein (LDL) cholesterol level and illness and death from coronary heart disease (CHD). A tendency to have a high cholesterol level is inherited (familial hypercholesterolemia, FH) in less than 5 percent of the cases; for the rest the origin is unknown, and there are probably several different causes. Patients with mild or moderate elevations of LDL cholesterol are at risk for CHD. Cholesterol-lowering drugs such as lovastatin and simvastatin are now in use. Pravastatin is in the same class of drugs, and has been found to have very few side effects in both humans and research animals. This is a report of a six-month segment of a two-year, multicenter study of 360 patients with high blood cholesterol who took either pravastatin or gemfibrozil, another lipid-lowering drug. Pravastatin lowered total cholesterol by 23 percent, primarily by lowering LDL cholesterol, which was reduced by 30 percent. Patients with primary hypercholesterolemia had a greater reduction in LDL cholesterol than those with FH, but both effects were significant. There were no significant side effects reported during the trial. Gemfibrozil reduced total cholesterol by only 14 percent and LDL cholesterol by 17 percent, but this smaller benefit was somewhat offset because gemfibrozil raised the level of high-density-lipoprotein (HDL) cholesterol by 13 percent, compared with a 5 percent increase in HDL with pravastatin (higher levels of HDL are thought to protect against heart disease). Pravastatin reached its maximum effect after four weeks, and this effect remained stable until the end of the trial (at 24 weeks). Because of differences in methodology and dosage used in other studies, it has not been possible to compare pravastatin to lovastatin. (Consumer Summary produced by Reliance Medical Information, Inc.)