07-18-2008
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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: dbeckerchcardiology@hotmail.com]
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