Crouse, professor of internal medicine (endocrinology/metabolism) and director of the Preventive Cardiology Program at the Wake Forest University Baptist Medical Center, said the study, together with other information presented at the meeting, re-emphasizes the importance of the so-called good cholesterol, high-density lipoprotein (HDL) cholesterol.

"These results suggest that HDL may have a greater import than we have given it," said Crouse, noting the emphasis in recent years on low density lipoprotein (LDL) and triglycerides.

The study involved 842 patients at 49 centers in 19 countries and compared two doses of two statin drugs -- simvastatin and atorvastatin. Both drugs raised HDL, particularly in patients who had an HDL cholesterol below 35 -- which National Cholesterol Education Program classifies as a "major risk factor for coronary heart disease." The effect was more dramatic for simvastatin.

Depending on the drug and the dose, the increase in HDL in patients who started the study with an HDL below 35 ranged from about 7 percent on the higher dose of atorvastatin to 18 percent on the higher dose of simvastatin. The HDL-raising effects of the lower doses of both drugs were in between.

In patients whose HDL cholesterol was above 35, the increases were less dramatic, with simvastatin doing about twice as well as atorvastatin at both doses.

According to the National Cholesterol Education Program, the higher the HDL, the better, and HDL above 60 appears to be protective against heart disease.

"We did not expect to see such dramatic effects of a statin on low HDL, nor did we expect to find that there was a differential effect between simvastatin and ator
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Contact: Robert Conn, Jim Steele or Mark Wright
rconn@wfubmc.edu
(336) 716-4587
Wake Forest University Baptist Medical Center
24-Aug-1998