Simvastatin and the apolipoprotein profile in primary hypercholesterolemia

We studied the effects of simvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase), administered for 24 weeks to a group of ten patients with primary hypercholesterolemia, in order to evaluate the drug's efficacy in improving the apolipoprotein profile. The patients received simvastatin once daily in dosages varying from 10 to 40 mg. Significant reductions were observed in total cholesterol (30%), low-density lipoprotein cholesterol (40%), total cholesterol/high-density lipoprotein cholesterol (47%), and apolipoprotein B (19%), and a significant increase in high-density lipoprotein (24%) and apolipoproteins AI (17%) and AII (25%). In only one patient was it necessary to also use cholestyramine to help correct the lipid levels. We may thus conclude that simvastatin, in a single daily dose, has a favorable effect on the lipid, lipoprotein, and apoliprotein profiles in a large proportion of patients with primary hypercholesterolemia.