Skip to main content
Log in

Effects of therapy with diet and simvastatin on atherosclerosis in hypercholesterolemic patients

  • Lipid Studies
  • Published:
Cardiovascular Drugs and Therapy Aims and scope Submit manuscript

Summary

We evaluated the effect of cholesterol reduction on atherosclerotic coronary artery lesions using diet and simvastatin, a potent HMG CoA reductase inhibitor. Fifteen subjects aged 28–69 years (mean 44), each of whom demonstrated significant (>50%) narrowing of a coronary artery and a baseline cholesterol level greater than 278 mg/dl, were studied. Coronary arteriography was performed prior to and after 20±2.5 months of therapy. A 42% reduction in total serum cholesterol, a 52% reduction in LDL cholesterol, and an 87% increase in the HDL/LDL cholesterol ratio (p<0.01) were achieved. Pretreatment and posttreatment angiograms were reviewed by three experienced angiographers with temporal order masked. Improvement in the overall status of coronary atherosclerotic lesions was demonstrated in two patients (13%), while deterioration occurred in one patient (7%). No overall change was found in the remaining 12 patients (80%). We conclude that a cholesterol-lowering regimen using a nonatherogenic diet and simvastatin therapy may at least stabilize coronary atherosclerosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mol MJTM, Erkelens DW, Gevers Leuven JA, et al. Effects of synvinolin (MK-733) on plasma lipids in familial hypercholesterolemia.Lancet 1986;2:936–939.

    PubMed  Google Scholar 

  2. Pietro DA, Alexander S, Mantell G, et al For the Simvastatin Multicenter Study Group II. Effects of simvastatin and probucol in hypercholesterolemia (Simvastatin Multicenter Study Group II).Am J Cardiol 1989;63:682–686.

    PubMed  Google Scholar 

  3. Yamamoto A, Sudo H, Endo A. Therapeutic effects of ML-236B in primary hypercholesterolemia.Atherosclerosis 1980;35:259–266.

    PubMed  Google Scholar 

  4. Tobert JA, Hitzenberger G, Kutovetz WR, et al. Rapid and substantial lowering of human serum cholesterol by mevinolin (MK-803), an inhibitor of HMGCoA reductase.Atherosclerosis 1982;41:61–65.

    PubMed  Google Scholar 

  5. Illingworth DR. Mevinolin plus colestipol in therapy for severe heterozygous familial hypercholesterolemia.Ann Intern Med 1984;101:598–604.

    PubMed  Google Scholar 

  6. Roberts WC. Factors linking cholesterol to atherosclerotic plaques.Am J Cardiol 1988;62:495–499.

    PubMed  Google Scholar 

  7. Canner PL, Berge KG, Wenger NK, et al. Fifteen year mortality in Coronary Drug Project patients: Long-term benefit with niacin.J Am Coll Cardiol 1986;8:1245–1255.

    PubMed  Google Scholar 

  8. Lipid Research Clinics Program. The Lipid Research Clinic Coronary Primary Prevention Trial results. I. Reduction in incidence of coronary heart disease.JAMA 1984;251:351–364.

    Google Scholar 

  9. Armstrong ML, Megan MB. Lipid depletion in atheromatous coronary arteries in rhesus monkeys after regression diet.Circ Res 1972;30:675–680.

    PubMed  Google Scholar 

  10. Clarkson TB, Bond MG, Bullock BC, et al., A study of atherosclerosis regression inMacaca mulatta.Exp Mol Pathol 1984;41:96–118.

    PubMed  Google Scholar 

  11. Vesselimovitch D, Wisler RW, Hugher R. Reversal of advanced atherosclerosis in rhesus monkeys.Atherosclerosis 1976;23:155–176.

    Google Scholar 

  12. Blankenhorn DH, Nessim SA, Johnson RL, et al. Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass graftsJAMA 1987;257:3233–3240.

    PubMed  Google Scholar 

  13. Brensike JF, Levy RI, Kelsey SF, et al. Effects of therapy with cholestyramine on progression of coronary atherosclerosis: Results of the NHLBI Type II Coronary Intervention Study.Circulation 1984;69:313–324.

    PubMed  Google Scholar 

  14. AHA Committee Report. Diet and coronary heart disease.Circulation 1978;58:762A–765A.

    Google Scholar 

  15. Warnick GR, Benderson J, Albers JJ. Dextran sulfate-Mg2+ precipitation procedure for quantitation of high-density lipoprotein cholesterol.Clin Chem 1982;28:1379–1388.

    PubMed  Google Scholar 

  16. Allain CC, Poon LS, Chan CS, et al. Enzymatic determination of total serum cholesterol.Clin Chem 1974;20:470–475.

    PubMed  Google Scholar 

  17. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clin Chem 1972;18:499–502.

    PubMed  Google Scholar 

  18. Bourassa MG, Enjalbert M, Campeau L, Lesperance J. Progression of atherosclerosis in coronary arteries and bypass grafts: Ten years later.Am J Cardiol 1984;53:102C-107C.

    PubMed  Google Scholar 

  19. Nash DT, Gensini G, Simon H, et al. The erysichthon syndrome, progression of coronary atherosclerosis and dietary hyperlipidemia.Circulation 1977;56:363–365.

    PubMed  Google Scholar 

  20. Nash DT, Caldwell N, Ancona D. Accelerated coronary artery disease arteriographically proved: Analysis of risk factors.NY State J Med 1974;74:947–950.

    Google Scholar 

  21. Anamarco ME, Brooks SH, Blankenhorn DH. Reproducibility of a consensus panel in the interpretation of coronary angiograms.Am Heart J 1978;96:430–437.

    PubMed  Google Scholar 

  22. Galbraith JE, Murphy ML, De Soyza N. Coronary angiogram interpretation.JAMA 1978;240:2053–2056.

    PubMed  Google Scholar 

  23. Nash DT, Gensini G, Ensente P. Effect of lipid-lowering therapy on the progression of coronary atherosclerosis assessed by scheduled repetitive coronary arteriography.Int J Cardiol 1982;2:43–55.

    PubMed  Google Scholar 

  24. Arntzenius AC, Kromhout D, Barth JD, et al. Diet, lipoproteins, and the progression of coronary atherosclerosis: The Leiden Intervention Trial.N Engl J Med 1985;312:805–811.

    PubMed  Google Scholar 

  25. Nikkila EA, Viikinkoski P, Valle M, et al. Prevention of coronary atherosclerosis by treatment of hyperlipidaemia. A seven year prospective angiographic study.Br Med J 1984;289:220–223.

    Google Scholar 

  26. Kuo PT, Hayase K, Kostis JB, et al. Use of combined diet and colestipol in long-term (7–7.5 years) treatment of patients with type II hyperlipoproteinemia.Circulation 1979;59:199–211.

    PubMed  Google Scholar 

  27. Duffield RG, Lewis B, Miller NE, et al. Treatment of hyperlipidaemia retards the progression of symptomatic femoral atherosclerosis. A randomized controlled trial.Lancet 1983;2:639–642.

    PubMed  Google Scholar 

  28. Ishikawa H, Uwatoko M, Watabe S, et al. Analysis of the evolution of coronary artery disease. Evaluation of 227 cases by restudy of coronary arteriography.Jpn Circ J 1986; 50:575.

    PubMed  Google Scholar 

  29. Visser RF, van der Werf T, Ascoop CAPL, Bruschke AVG. The influence of anatomic evolution of coronary artery disease on left ventricular contraction: An angiographic follow up study of 300 non-operated patients.Am Heart J 1986;112:963.

    PubMed  Google Scholar 

  30. Bruschke AVG, Kramer JR, Bal ET, et al. The dynamics of progression of coronary atherosclerosis studied in 168 medically treated patients who underwent coronary arteriography three times.Am Heart J 1989;117:296–305.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Barlow, C.W., Friedman, B.M., Myburgh, D.P. et al. Effects of therapy with diet and simvastatin on atherosclerosis in hypercholesterolemic patients. Cardiovasc Drug Ther 4, 1389–1394 (1990). https://doi.org/10.1007/BF02018267

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02018267

Key Words

Navigation