The effect of four-year hypolipidaemic treatment on the intimal thickness of the common carotid artery in patients with familiar hyperlipidaemia

Background. Cholesterol lowering in patients with above-average cholesterol levels has been shown to reduce the progression of atherosclerosis, We ass ess the effects of lipid lowering therapy on the progression of early, prei ntrusive carotid arterial atherosclerosis in high risk patients with famili al hyperlipidaemia free of symptomatic cardiovascular disease. Methods. Fifty-two patients with familial hyperlipidaemia by were treated b y diet and various hypolipidaemic drugs. Eighteen individuals were not taki ng hypolipidaemic drugs. In a prospective study by B-mode ultrasound we ass essed the intima-media thickness of the distal common carotid arterial (CCA ) far wall at baseline and after 4 years. Results. In a subgroup of 25 patients with familial hypercholesterolaemia t here was a significant decrease in total and LDL cholesterol and reduction in the intima-media thickness (IMT) of the common carotid artery from 0.78/-0.22 mm to 0.69+/-0.17 mm (p=0.004). In a subgroup of 27 patients with fa milial combined hyperlipidaemia significant decreases in total and LDL chol esterol and triglycerides were associated with a decrease in the IMT of com mon carotid. artery from 0.72+/-0.22 mm to 0.67+/-0.15 mm (p=0.044). In 18 individuals, who were not taking hypolipidaemic drugs, there were no signif icant changes in the levels of cholesterol and triglycerides and in the IMT of the common carotid artery (increase from 0.58+/-0.18 mm to 0 62+/-0.13 mm, p>0.05). Conclusions. Lipid-lowering therapy in patients with familial hyperlipidaem ia free of symptomatic cardiovascular disease reverses the progression of e arly, preintrusive atherosclerosis of the carotid artery. It is a beneficia l sign indicating the possibility for atherosclerosis regression.