GENDER-RELATED RESPONSE TO FLUVASTATIN IN PATIENTS WITH HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA

Hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitors are po tent cholesterol reducing agents that have been successfully used for the treatment of heterozygous familial hypercholesterolaemia (FH). A r ecent investigation revealed that several constitutional and genetic f actors significantly determined the response of plasma lipids and lipo proteins to the HMG CoA reductase inhibitor fluvastatin. Gender has be en identified through multivariate analysis as a major determinant of the plasma high density lipoprotein (HDL) cholesterol response. The cu rrent analysis was undertaken to determine possible gender-related flu vastatin dose-response differences. The analysis revealed that for HDL cholesterol, gender-related differences reach statistical significanc e only at the highest fluvastatin dose of 40 mg/day (females 22.9%, ma les 12.9%, p < 0.01). In parallel, the change in low density lipoprote in (LDL) cholesterol:HDL cholesterol ratio, an indicator of ischaemic heart disease risk, was also found to be affected by gender (females - 38.4%, males -32.2%, p < 0.01). For LDL cholesterol, no consistent gen der-related differences were found. In conclusion, the response of pla sma lipid levels to fluvastatin in heterozygote FH patients is signifi cantly affected by gender, with females achieving a more marked overal l response, as indicated by higher HDL cholesterol levels and a lower LDL cholesterol: HDL cholesterol ratio.