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The effect of gemfibrozil, niacin and cholestyramine combination therapy on metabolic syndrome in the Armed Forces Regression Study.

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Date
2011-05
Authors
Krasuski, Richard A
Devendra, Ganesh P
Cater, George
Whitney, Edwin J
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Abstract
INTRODUCTION: Metabolic syndrome is a powerful predictor of cardiovascular events independent of overt diabetes. Dietary restriction and weight loss modify metabolic syndrome components. This study addresses whether combination pharmacologic therapy focused on dyslipidemia provides additional benefit. METHODS: This study examines the effect of 1 year of gemfibrozil, niacin and cholestyramine therapy on a baseline of aggressive dietary and lifestyle intervention in 143 clinically stable, nondiabetic patients with coronary disease, randomized into a double-blind, placebo-controlled trial. RESULTS: Cohort characteristics included age 63 ± 7 years, 92% men, 43% with previous myocardial infarction, systolic blood pressure 139 ± 17 mm Hg, triglycerides 168 ± 81 mg/dL and high-density lipoprotein cholesterol 34 ± 6 mg/dL. The mean number of metabolic syndrome components decreased from 2.2 ± 0.9 to 1.5 ± 1.1, P < 0.001, and metabolic syndrome prevalence decreased from 38% to 18% (P < 0.001) for the entire cohort. In the lifestyle intervention and placebo group, the mean number of metabolic syndrome components decreased from 2.2 ± 0.9 to 1.9 ± 1.1 (P = 0.01), and prevalence of metabolic syndrome decreased from 44% to 30% (P = 0.15). A far more marked change was observed with lifestyle intervention and pharmacologic therapy: abnormal metabolic components decreased from 2.2 ± 0.9 to 1.0 ± 1.0 (P < 0.001), and prevalence of metabolic syndrome decreased from 32% to 6% (P < 0.001). CONCLUSIONS: The combination of gemfibrozil, niacin and cholestyramine has profound, beneficial effects on the components of metabolic syndrome. These benefits are additive to those seen with aggressive diet and lifestyle modification.
Type
Journal article
Subject
Aged
Anticholesteremic Agents
Body Mass Index
Cholestyramine Resin
Double-Blind Method
Drug Therapy, Combination
Female
Gemfibrozil
Humans
Hypolipidemic Agents
Life Style
Lipids
Longitudinal Studies
Male
Metabolic Syndrome X
Middle Aged
Military Personnel
Niacin
Treatment Outcome
Permalink
https://hdl.handle.net/10161/11029
Published Version (Please cite this version)
10.1097/MAJ.0b013e318209d851
Publication Info
Krasuski, Richard A; Devendra, Ganesh P; Cater, George; & Whitney, Edwin J (2011). The effect of gemfibrozil, niacin and cholestyramine combination therapy on metabolic syndrome in the Armed Forces Regression Study. Am J Med Sci, 341(5). pp. 378-382. 10.1097/MAJ.0b013e318209d851. Retrieved from https://hdl.handle.net/10161/11029.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Krasuski

Richard Andrew Krasuski

Professor of Medicine
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