ASSESSING THE INDEPENDENT EFFECT OF DIETARY COUNSELING AND HYPOLIPIDEMIC MEDICATIONS ON SERUM-LIPIDS

Determination of changes in total cholesterol (TC) and triglyceride (T G) levels has focused primarily on hypolipidemic drug effects. Changes resulting from dietary effect alone versus diet and drug effect have not yet been fully established. Seventy subjects were enrolled into fo ur treatment groups to determine the impact of diet and drug effect up on TC and TG. Group 1 (n = 28) served as the control group and receive d no dietary counseling or drug therapy. Group 2 (n = 22) received die tary counseling. Group 3 (n = 7) underwent dietary counseling for six months and drug therapy for eighteen months. Subjects in groups 1-3 we re monitored for eighteen months. Patients in group 4 (n = 13) were fo llowed up for thirty-six months. No intervention occurred during the f ir st eighteen months, and hypolipidemic medications were used during the second eighteen-month period. Subjects in groups 1 and 4 received no specific dietary counseling and demonstrated no significant improve ment over the course of the study. Patients in groups 2 and 3 showed s ignificant reductions in both TC and TG. The improvement in TC seen fo r patients in group 3 was reduced after dietary counseling ceased.Diet ary intervention is necessary if patients are to statistically signifi cantly reduce TC and TG levels, Drug therapy demonstrated the expected reductions in both TC and TG but: did not statistically significantly lower lipid levels without: concomitant dietary counseling, When diet ary counseling and hypolipidemic medications are used together, reduct ions in TC and TG values are even greater than those seen with dietary effect alone. Diet control alone appears to significantly reduce TC a nd TG levels, resulting in reduced need for antianginal medications.