The effect of gemfibrozil, niacin and cholestyramine combination therapy on metabolic syndrome in the Armed Forces Regression Study.
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 articleSubject
AgedAnticholesteremic 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
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https://hdl.handle.net/10161/11029Published Version (Please cite this version)
10.1097/MAJ.0b013e318209d851Publication 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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Richard Andrew Krasuski
Professor of Medicine

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