EFFECTS OF PHENYTOIN ON PLASMA HIGH-DENSITY-LIPOPROTEIN CHOLESTEROL LEVELS IN MEN WITH LOW-LEVELS OF HIGH-DENSITY-LIPOPROTEIN CHOLESTEROL

A low level of high-density lipoprotein cholesterol (HDL-C) is an impo rtant and common risk factor for coronary heart disease, Cross-section al studies and uncontrolled clinical trials have suggested that phenyt oin can significantly raise HDL-C levels. This study was undertaken to determine whether phenytoin can mise HDL-C levels in men with low lev els of HDL-C., Ninety-two men currently receiving outpatient care at a Veterans Affairs medical center and with baseline HDL-C levels less t han or equal to 1.16 mmol/L (45 mg/dL) were recruited to participate i n this randomized, placebo-controlled, double-blind clinical trial, Pa rticipants received a placebo or 100 mg, 200 mg, or 300 mg of phenytoi n once daily for 14 weeks. Lipid levels were measured at baseline and at 6, 10, and 14 weeks. After 14 weeks of treatment, the 200-mg and 30 0-mg phenytoin groups together achieved a significant 10% increase in HDL-C levels compared with placebo after adjusting for differences in baseline HDL-C levels, age, and body mass index. Other lipid levels di d not significantly change in the phenytoin groups compared with place bo. Average compliance was 98% or greater for each of the treatment gr oups, Eighteen participants dropped out of the study with similar numb ers from each treatment group. Side effects-were mild and mostly trans ient. Low doses of phenytoin are well tolerated and can effectively in crease HDL-C levels in men with low levels of HDL-C.