EFFICACY AND SAFETY OF PRAVASTATIN IN AFRICAN-AMERICANS WITH PRIMARY HYPERCHOLESTEROLEMIA

被引:24
作者
JACOBSON, TA
CHIN, MM
CURRY, CL
MILLER, V
PAPADEMETRIOU, V
SCHLANT, RC
LAROSA, JC
机构
[1] HOWARD UNIV HOSP,COLL PHARM & SCI,DIV CARDIOVASC DIS,WASHINGTON,DC
[2] GEORGE WASHINGTON UNIV,MED CTR,LIPID RES CLIN,WASHINGTON,DC 20037
[3] VET AFFAIRS MED CTR,WASHINGTON,DC 20422
关键词
D O I
10.1001/archinte.155.17.1900
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Coronary artery disease strikes early and may prove particularly severe in persons of African-American descent. Therefore, we studied the lipid-lowering efficacy and safety of pravastatin sodium (20 mg/d), a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, in 245 African-American patients with primary hypercholesterolemia. Methods: After 4 weeks on an American Heart Association phase I low-fat diet, patients were randomized in a double-blind manner to either pravastatin or placebo in a 3:1 ratio. Results: After 12 weeks of pravastatin treatment, low-density lipoprotein cholesterol Ievels declined 25.8%, total cholesterol levels 20.3%, and triglyceride levels 6.2%, while high-density lipoprotein cholesterol levels remained essentially unchanged. Overall, 72% of pravastatin-treated patients achieved reductions in low-density lipoprotein cholesterol level in excess of 20%, and 44%, attained declines in excess of 30% (both P<.01 vs placebo). Pravastatin was generally well tolerated in this population, with one patient (0.5%) exhibiting a reversible myopathy with creatine kinase elevations to 10 times the upper limit of normal. No substantial elevations of aminotransferase levels of two to three times the upper limit of normal occurred in either the pravastatin or the placebo group. Drug compliance was high, exceeding 90%. Conclusion: Pravastatin appears to be an effective and safe lipid-lowering agent and is the first 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor to be studied extensively in this underrepresented population.
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页码:1900 / 1906
页数:7
相关论文
共 56 条
[1]  
[Anonymous], 1993, AM J CARDIOL, V72, P1031
[2]   LOVASTATIN AND RHABDOMYOLYSIS [J].
AYANIAN, JZ ;
FUCHS, CS ;
STONE, RM .
ANNALS OF INTERNAL MEDICINE, 1988, 109 (08) :682-683
[3]   HEART-DISEASE IN BLACK-AND-WHITE [J].
AYANIAN, JZ .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 329 (09) :656-658
[4]   BENEFICIAL-EFFECTS OF COMBINED COLESTIPOL-NIACIN THERAPY ON CORONARY ATHEROSCLEROSIS AND CORONARY VENOUS BYPASS GRAFTS [J].
BLANKENHORN, DH ;
NESSIM, SA ;
JOHNSON, RL ;
SANMARCO, ME ;
AZEN, SP ;
CASHINHEMPHILL, L .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1987, 257 (23) :3233-3240
[5]   EXPANDED CLINICAL-EVALUATION OF LOVASTATIN (EXCEL) STUDY RESULTS .1. EFFICACY IN MODIFYING PLASMA-LIPOPROTEINS AND ADVERSE EVENT PROFILE IN 8245 PATIENTS WITH MODERATE HYPERCHOLESTEROLEMIA [J].
BRADFORD, RH ;
SHEAR, CL ;
CHREMOS, AN ;
DUJOVNE, C ;
DOWNTON, M ;
FRANKLIN, FA ;
GOULD, AL ;
HESNEY, M ;
HIGGINS, J ;
HURLEY, DP ;
LANGENDORFER, A ;
NASH, DT ;
POOL, JL ;
SCHNAPER, H .
ARCHIVES OF INTERNAL MEDICINE, 1991, 151 (01) :43-49
[6]   EFFECTS OF THERAPY WITH CHOLESTYRAMINE ON PROGRESSION OF CORONARY ARTERIOSCLEROSIS - RESULTS OF THE NHLBI TYPE-II CORONARY INTERVENTION STUDY [J].
BRENSIKE, JF ;
LEVY, RI ;
KELSEY, SF ;
PASSAMANI, ER ;
RICHARDSON, JM ;
LOH, IK ;
STONE, NJ ;
ALDRICH, RF ;
BATTAGLINI, JW ;
MORIARTY, DJ ;
FISHER, MR ;
FRIEDMAN, L ;
FRIEDEWALD, W ;
DETRE, KM ;
EPSTEIN, SE .
CIRCULATION, 1984, 69 (02) :313-324
[7]   REGRESSION OF CORONARY-ARTERY DISEASE AS A RESULT OF INTENSIVE LIPID-LOWERING THERAPY IN MEN WITH HIGH-LEVELS OF APOLIPOPROTEIN-B [J].
BROWN, G ;
ALBERS, JJ ;
FISHER, LD ;
SCHAEFER, SM ;
LIN, JT ;
KAPLAN, C ;
ZHAO, XQ ;
BISSON, BD ;
FITZPATRICK, VF ;
DODGE, HT .
NEW ENGLAND JOURNAL OF MEDICINE, 1990, 323 (19) :1289-1298
[8]   15 YEAR MORTALITY IN CORONARY DRUG PROJECT PATIENTS - LONG-TERM BENEFIT WITH NIACIN [J].
CANNER, PL ;
BERGE, KG ;
WENGER, NK ;
STAMLER, J ;
FRIEDMAN, L ;
PRINEAS, RJ ;
FRIEDEWALD, W .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1986, 8 (06) :1245-1255
[9]   BENEFICIAL-EFFECTS OF COLESTIPOL-NIACIN ON CORONARY ATHEROSCLEROSIS - A 4-YEAR FOLLOW-UP [J].
CASHINHEMPHILL, L ;
MACK, WJ ;
POGODA, JM ;
SANMARCO, ME ;
AZEN, SP ;
BLANKENHORN, DH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1990, 264 (23) :3013-3017
[10]  
COOPER R, 1985, NEW YORK STATE J MED, V85, P344