HEMORHEOLOGY AND QUALITY-OF-LIFE IN LIPID -LOWERING AND FIBRINOGEN-LOWERING THERAPY

Previous studies have demonstrated that heparin-induced extracorporeal LDL precipitation is able to reduce total cholesterol, LDL, triglycer ides and plasma fibrinogen at the same time and thus improve the hemor heologic pattern. A combination of H.E.L.P. and bezafibrate, which als o has a lipid- and fibrinogen-lowering potency, was applied in patient s suffering from cerebral multiinfarct dementia and disturbances of th e hemorheologic situation. In view of observations regarding improved quality of life after H.E.L.P., a prospective, randomized trial was co nducted to determine possible interactions between improved hemorheolo gy and better quality of life. To obtain a low baseline of laboratory parameters, all the patients underwent a single H.E.L.P. session and w ere then (doubleblind) stratified into 2 groups: group 1 (16 males, 5 females, age 67.9 +/- 6.8 years) received sustained-release bezafibrat e 400 mg (Bezalip(TM)) per day, while group 2 served as controls, and comprised 14 males and 5 females (age 69.2 +/- 6.8 years) who received placebo for a period of 56 days. After H.E.L.P. a statistically signi ficant reduction of the following parameters relevant to hemorheology was obtained: fibrinogen (p<0.0001), whole blood viscosity (low shear rate p<0.007 and high shear rate p<0.005), plasma viscosity (p<0.002) and red cell transit time (p<0.0001). Also, the metabolic parameters w ere influenced positively (p<0.0001 for total cholesterol, LDL and tri glycerides). These favourable results remained in the bezafibrate grou p until day 56 when a significant difference in relation to the contro ls appeared with respect to fibrinogen (p<0.05), whole blood viscosity (low shear p<0.03, high shear rate p<0.002), plasma viscosity (p<0.00 02), red cell transit time (p<0.004), LDL (p<0.05), and triglycerides (p<0.01). Life quality was measured by Grogono's index. Two days after H.E.L.P. a significant improvement was observed (p<0.001 and p<0.005 respectively). This positive development persisted only in the bezafib rate group (p<0.001). At the end of the trial the difference between b oth groups became statistically significant (p<0.01). The results obta ined strongly support the relationship between an ameliorated hemorheo logical situation and better quality of life.