Joint effects of HMG-CoA reductase inhibitors and eicosapentaenoic acids on serum lipid profile and plasma fatty acid concentrations in patients withhyperlipidemia

HMG-CoA reductase inhibitors reduce serum total cholesterol concentrations and the risk of coronary heart disease in patients with hypercholesterolemi a. Recently, it has been reported that patients with combined hyperlipidemi a are also at risk of coronary heart disease. However, HMG-CoA reductase in hibitor therapy alone does not sufficiently reduce serum triglyceride conce ntrations. Epidemiological and clinical evidence has shown that fish oil ca n lower plasma lipid levels, especially triglycerides. Consequently, we inv estigated the effects of the combination of HMG-CoA reductase inhibitors an d eicosapentaenoic acid, a major component of fish oil, on hyperlipidemia. We administered 900-1,800 mg/day of the ethyl ester of eicosapentaenoic aci d to patients with hyperlipidemia who had been treated with HMG-CoA reducta se inhibitors for 30 +/- 6 months (means +/- SE). Serum total cholesterol a nd triglyceride concentrations were significantly decreased 3 months after the administration of eicosapentaenoic acid (from 5.63 +/- 0.23 mmol/l to 5 .02 +/- 0.20 mmol/l, P<0.05; from 2.07 +/- 0.41 mmol/l to 1.08 +/- 0.17 mmo l/l, P<0.01, respectively). Serum high-density lipoprotein-cholesterol conc entrations were significantly increased after the treatment(from 1.23 +/- 0 .12 mmol/l to 1.34 +/- 0.13 mmol/l, P<0.05). Plasma eicosapentaenoic acid c oncentrations and the ratio to arachidonic acid in plasma were also signifi cantly increased 3 months after the treatment (from 101.9 +/- 8.1 mg/l to 1 81.8 +/- 23.9 mg/l, P<0.001; from 0.640 +/- 0.075 to 1.211 +/- 0.170, P<0.0 01, respectively). These results suggested that the combination therapy of HMG-CoA reductase inhibitors and eicosapentaenoic acid was effective for pa tients with hyperlipidemia.