Previous Page | Next Page
Cholesterol
A large VA study now shows that RAISING low HDL cholesterol prevents MI and stroke.
About 30% of coronary heart disease patients have normal LDL... but low HDL. An HDL < 35 mg/dL is considered a risk factor for CHD.
New research shows that using gemfibrozil in these patients reduces the risk of death.. .MI.. .and stroke about 20%.
In fact, you need to treat only 23 patients with CHD and low HDL with gemfibrozil for 5 years to prevent one MI or death from heart disease.
Gemfibrozil (Lopid) primarily increases HDL and lowers triglycerides.. .it doesn't have much effect on LDL.
Most of the cholesterol-lowering drugs increase MDL.. .but some are more effective than others.
The increase in HDL is about 15% to 30% with niacin.. .5% to 16% with statins. . .6% to 11% with gemfibrozil or fenofibrate (Tz-icor) .. .and 1% to 5% with cholestyramine or colestipol.
In fact, Zocor (simvastatin) is now approved specifically for increasing MDL.. . in patients who also have high LDL. It's the first statin to get this indication.
Aim for an MDL of 45 mg/dL f or men. . .55 mg/dL for women.
Encourage patients to try to increase MDL with weight loss. . .exercise.. .and smoking cessation.
Previous Page | Next Page
Return to the Perry
Hookman, M.D., P.A. Home Page