DOSE-DEPENDENT EFFECT OF HYDROXYMETHYLGLUTARYL-COENZYME-A REDUCTASE INHIBITOR ON SERUM-CHOLESTEROL WITH LIMITED DIETARY RESTRICTIONS - A CASE-STUDY

Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (pravas tatin sodium) can selectively inhibit cholesterol biosynthesis in the liver and may lower serum cholesterol concentrations even where there are no particular dietary restrictions. A 72-year old housewife with n on-insulin-dependent diabetes mellitus complicated by hyperlipaemia ty pe IIb, who did not follow directions for diet therapy or kinesitherap y, was administered HMG-CoA reductase inhibitor. The initial dose of 1 0 mg/day HMG-CoA reductase inhibitor was increased by 10 mg/day every 4 weeks to 30 mg/day, maintained at 30 mg/day for 8 weeks and then red uced gradually until discontinuation after a further 27 weeks. Test re sults showed the changes in low-density lipoprotein cholesterol and ap oprotein B to be dose-dependent. The findings represent the first clin ical evidence that hypercholesterolaemia can be adequately managed by the use of HMG-CoA reductase inhibitor, even when no specific dietary restrictions are imposed, and may contribute to improvements in the qu ality of daily life for many patients suffering from hyperlipaemia typ e IIb.