Effects of bezafibrate and simvastatin on plasma lipoproteins in hypercholesterolemia resistant to hormone replacement therapy

Objectives: Estrogen replacement therapy has favorable effects on serum lip oprotein levels in postmenopausal women with hypercholesterolemia. However. there are some patients who fail to respond to hormone replacement therapy (HRT) to lower the serum cholesterol level. In these cases a conventional lipid-lowering therapy will be applied in addition to HRT, while the effect s: of these drugs are not well understood. In this study, we studied the ef fects of simvastatin and bezafibrate administered in addition to HRT. Metho ds: Patients who were hypercholesterolemic even after HRT were randomly ass igned to three treatment groups: HRT only (control group, n = 10). HRT + si mvastatin (10 mg/day. n = 10), or HRT + bezafibrate (400 mg/day, n = 10). S erum lipids and lipoprotein levels were measured throughout 12 weeks. Resul ts: The serum triglyceride levels were decreased by 24 +/- 28 and 38 +/- 13 % in the HRT + simvastatin and HRT + bezafibrate groups, respectively. HRT + simvastatin decreased the total cholesterol (21 +/- 10%) and low-density lipoprotein cholesterol (28 +/- 12%) levels without affecting the high-dens ity lipoprotein cholesterol (HDL-C) level, while HRT + bezafibrate increase d the HDL-C level (12 +/- 11%). Conclusions: Treatment with simvastatin or bezafibrate in addition to HRT should be considered in cases of postmenopau sal hypercholesterolemia in which HRT alone fails to lower the serum lipopr otein levels. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.