SIMVASTATIN AND PRAVASTATIN - A DAILY DOSE OF 40 MG IN THE LONG-TERM TREATMENT OF PRIMARY HYPERCHOLESTEROLEMIA

This study was conducted to evaluate whether an increase in simvastati n and pravastatin dosage can produce a further reduction in plasma tot al cholesterol (TC) in patients who do not show adequate responses to lower doses. The efficacy and tolerance of long-term treatment (12 mon ths) were also evaluated. Full doses of simvastatin and pravastatin we re given to a group of 25 patients with primary hypercholesterolemia. Fourteen patients were given a daily dose of 40 mg of simvastatin and 11 patients were given the same daily dose of pravastatin. All patient s were affected by heterozygous familial hypercholesterolemia (lipopro tein phenotype IIa). These patients showed poor reduction of plasma ap olipoprotein B-containing lipoprotein levels when treated with simvast atin and pravastatin at lower doses (20 to 30 mg/day). After 6 and 12 months there were statistically significant decreases in plasma non-hi gh-density lipoprotein cholesterol (non-HDL-C) levels. The ratio, HDL- C/TC-HDL-C, named HDL-C ratio, increased following treatment with simv astatin and pravastatin. As expected, the results indicated more signi ficant decreases in plasma HDL-C levels with simvastatin than with pra vastatin. Both drugs were well tolerated at a dose of 40 mg/day.