CHANGES IN PLASMA-LIPIDS, LIPOPROTEINS AND APOLIPOPROTEINS IN HYPERCHOLESTEROLEMIC PATIENTS TREATED WITH PRAVASTATIN

Plasma lipids, lipoproteins and apolipoproteins were studied before an d during 6 months of pravastatin administration in patients with hyper cholesterolaemia. After a 1 month placebo run-in period, the patients were treated double-blind either with placebo (n = 25) or with pravast atin (n = 25) for 6 months. Placebo or pravastatin 10 mg during the fi rst month, 20 mg during the second month and 40 mg during the addition al 4 months was administered once daily in the evening. Compared with the placebo group the plasma concentration of total cholesterol and ph ospholipids, free cholesterol and cholesterol esters as well as the pl asma LDL-cholesterol and LDL-phospholipids were decreased during 6 mon ths of pravastatin therapy. No changes in plasma VLDL-, HDL-, HDL(2)- or HDL(3)-cholesterol, -phospholipids or -triglycerides were observed in the pravastatin-treated patients. A decrease in the plasma level of apolipoprotein B and of LDL-apo B, but not of VLDL-apo B, was observe d during pravastatin therapy; the plasma apolipoprotein Al and All lev els as well as HDL(2)- and HDL(3)-apo Al and apo All levels remained, however, unchanged. Plasma lipoprotein Lp(a) did not change during pra vastatin therapy whereas the plasma lecithin cholesterol acyltransfera se activity (LCAT) increased. In conclusion, treatment of hypercholest erolaemic patients with pravastatin results in a decrease in the plasm a concentration of total and free cholesterol, LDL-cholesterol, apolip oprotein B, LDL-apo B, phospholipids and cholesterol esters and in an increase in plasma LCAT activity. Plasma Lp(a), HDL-cholesterol and tr iglyceride levels remained, however, unchanged.