COMPARISON OF 2 CHOLESTEROL-SYNTHESIS INH IBITORS - SIMVASTATIN AND PRAVASTATIN

Inhibitors of cholesterol synthesis (HMG-CoA reductase) are the most e ffective cholesterol-lowering drugs. Comparison of several studies in the literature suggests that simvastatin is approximately twice as eff ective as pravastatin on a milligram basis. These results are confirme d by the present study, which compares treatment with simvastatin (10 mg/d) with pravastatin (20 mg/d) in the same hypercholesterolemic pati ents (n = 17). The reduction in LDL cholesterol is the same with twice the dose of pravastatin as with simvastatin (26+/-3% vs 27+/-2% respe ctively). The reductions in atherogenic ratios, total cholesterol, HDL cholesterol and ApoB/ApoA1 are similar. Undesirable effects are rare and comparable. The differences between the two inhibitors appear to b e on the molecular level, in tissue selectively and regarding in vivo efficacy.