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Simvastatin vs therapeutic lifestyle changes and supplements: Randomized primary prevention trial – Source: Mayo Clinic Proceedings, Jul 2008

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[Note: Statins, such as simvastatin, are cholesterol-lowering prescription drugs.]

Objective: To compare the lipid-lowering effects of an alternative regimen (lifestyle changes, red yeast rice, and fish oil) with a standard dose of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin).

Patients and Methods: This randomized trial enrolled 74 patients with hypercholesterolemia [high cholesterol] who met Adult Treatment Panel III criteria for primary prevention using statin therapy.

All participants were randomized to an alternative treatment group (AG) or to receive simvastatin (40 mg/d) in this open-label trial conducted between April 1, 2006, and June 30, 2006.

The alternative treatment included:

  • Therapeutic lifestyle changes,

  • Ingestion of red yeast rice,

  • And fish oil supplements, for 12 weeks.

  • The simvastatin group received medication and traditional counseling.

    The primary outcome measure was the percentage change in low-density lipoprotein cholesterol (LDL-C)[referred to as ‘bad’ cholesterol]. Secondary measures were changes in other lipoproteins and weight loss.

    Results:

  • There was a statistically significant reduction in LDL-C levels in both the AG (-42.4%+/-15%) (P<.001) and the simvastatin group (-39.6%+/-20%) (P<.001).

  • No significant differences were noted between groups.

  • The alternative treatment group also demonstrated significant reductions in triglycerides (-29% vs -9.3%; 95% confidence interval, -61 to -11.7; P=.003) and weight (-5.5% vs -0.4%; 95% confidence interval, -5.5 to -3.4; P<.001) compared with the simvastatin group.

  • Conclusion: Lifestyle changes combined with ingestion of red yeast rice and fish oil reduced LDL-C in proportions similar to standard therapy with simvastatin.

    Pending confirmation in larger trials, this multifactorial, alternative approach to lipid lowering has promise for a subset of patients unwilling or unable to take statins.

    Source: Mayo Clinic Proceedings. Jul 2008;83(7):758-64. PMID: 18613992, by Becker DJ, Gordon RY, Morris PB, Yorko J, Gordon YJ, Li M, Iqbal N. Division of Cardiology, Chestnut Hill Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA. [E-mail: <a href="mailto:dbeckerchcardiology@hotmail.com”>dbeckerchcardiology@hotmail.com]

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