Effects of simvastatin only or in combination with continuous combined hormone replacement therapy on serum lipid levels in hypercholesterolaemic post-menopausal women

Aims To evaluate the effects of simvastatin only or combined with continuou s hormone replacement therapy on the serum lipid profile in hypercholestero laemic post-menopausal women. Methods and Results One hundred hypercholesterolaemic post-menopausal women were given either simvastatin 10 mg daily together with oestrogen 0.625 mg and medroxyprogesterone 2.5 mg daily (HRT + simvastatin group) (n:50) or s imvastatin 10 mg daily (simvastatin only group) (n:50) in a prospective man ner. Serum total, low density lipoprotein, and high density lipoprotein cho lesterol and triglyceride levels were measured at baseline, at 3 and 6 mont hs. The initial mean (+/- SD) cholesterol values were as follows for the HR T + simvastatin group and the simvastatin only group, respectively: total c holesterol 240.0 +/- 28.0 and 248.9 +/- 28.2 mg . dl(-1) ; low density lipo protein cholesterol 174.7 +/- 25.6 and 175.1 +/- 25.9 mg . dl(-1); high den sity lipoprotein cholesterol 37.2 +/- 5.0 and 39.9 +/- 7.3 mg . dl(-1) Comp ared with the baseline, total and low density lipoprotein cholesterol level s decreased; and high density lipoprotein cholesterol levels increased sign ificantly at 3 and 6 months in both groups. However, the mean percent reduc tion in total cholesterol and low density lipoprotein cholesterol was signi ficantly greater in the HRT + simvastatin group compared with the simvastat in only group both at 3 months (12.3 +/- 7.0% vs 8.9 +/- 6.2%; P < 0.01; an d 19.0 +/- 10.6% vs 13.2 +/- 10.4%; P < 0.005, respectively) and at 6 month s (14.6 +/- 7.7% vs 11.3 +/- 7.4%; P < 0.05 and 23.3 +/- 9.7% vs 15.8 +/- 1 2.3%; P < 0.005, respectively). The mean percent increase in serum high den sity lipoprotein cholesterol concentrations was also significantly greater in the HRT + simvastatin group compared with the simvastatin only group at both times (14.6 +/- 11.8% vs 9.8 +/- 11.8%; P < 0.005, at 3 months, and 21 .3 +/- 15.2% vs 11.1 +/- 12.5; P < 0.005, at 6 months, respectively). Furth ermore, significantly more patients in the HRT + simvastatin group than in the simvastatin only group attained their target treatment goals dictated b y the National Cholesterol Education Program Adult Treatment Panel II Guide lines. Although the mean percent decrease in triglyceride levels was signif icantly greater in the HRT + simvastatin group at 3 months, the significanc e disappeared at 6 months. Conclusion The combination of simvastatin and continuous combined hormone r eplacement therapy seems to be more effective than simvastatin only in the treatment of hypercholesterolaemia in post-menopausal women. (C) 2000 The European Society of Cardiology.