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

Krasuski, Richard A

Devendra, Ganesh P

Cater, George

Whitney, Edwin J

United States

2015-12-03T17:50:06Z

2011-05

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.

http://www.ncbi.nlm.nih.gov/pubmed/21358314

S0002-9629(15)31293-3

1538-2990

https://hdl.handle.net/10161/11029

eng

Elsevier BV

Am J Med Sci

10.1097/MAJ.0b013e318209d851

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

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

Journal article

Krasuski, Richard A|0000-0003-3150-5215

http://www.ncbi.nlm.nih.gov/pubmed/21358314

378

382

5

Clinical Science Departments

Duke

Medicine

Medicine, Cardiology

School of Medicine

Published

341