GENDER AND DIET INTERACTIONS WITH SIMVASTATIN TREATMENT

Twelve men and thirteen women with hypercholesterolaemia participated in a 20-week controlled cross-over trial to assess the interaction bet ween dietary fat intake, gender and an HMGCoA reductase inhibitor, sim vastatin. Subjects were matched for total cholesterol, age, body mass index (BMI) and plasma triglyceride. Gender-drug interactions were not ed with men demonstrating only a 27% fall in LDL cholesterol with simv astatin when consuming a high fat (40% energy) diet compared to women with a 35% fall. In men, the lowest LDL/HDL ratio was achieved with si mvastatin on a low fat diet (22% energy). Gender differences in the ef fect of simvastatin on HDL were confined to HDL, cholesterol, although the drug raised HDL, in both sexes on the low fat diet. Simvastatin w as responsible for an 11% increase in HDL, cholesterol in men particul arly when on a low fat diet but did not affect HDL(3) in women. An imp ortant diet-drug interaction was seen in triglyceride response, with a lowering of 17%-20% only when subjects were on a low fat diet. There was a gender difference in response to dietary fat change with men dem onstrating a 19% decrease in triglycerides with dietary fat reduction while on simvastatin, whereas women showed a 9% increase which did not reach significance. Men also responded more favourably to dietary fat reduction with at least two-fold greater falls in plasma cholesterol than was seen in women. This study indicates that a low fat diet influ ences the response to simvastatin more favourably in men than in women with greater reductions in LDL cholesterol, LDL/HDL ratio and triglyc eride as well as greater elevations of HDL cholesterol.