[Results of clinical epidemiology and intervention trial of hyperlipidemia in Japan]

Abstract

Recently, three large-scale clinical studies on hypercholesterolemia have been reported in Japan. The Kyushu Lipid Intervention Study(KLIS) was initiated investigate the effect of pravastatin, as compared with conventional hypolipidemic treatment, in the primary prevention of not only coronary events but also cerebral infarction in Japanese men with serum total cholesterol levels of 220 mg/dl or greater. A total of 5,640 patients were recruited. Adjusted relative risks of outcomes combined coronary events and cerebral infarction for pravastatin versus conventional treatment was 0.81(p = 0.08). The Pravastatin Anti-atherosclerosis Trial in the Elderly(PATE) is a prospective randomized controlled trial to determine the effectiveness of pravastatin on the incidence of cardiovascular events by comparing the effect of low dose(group L, 5 mg/day, n = 334) with the standard dose(group S, 10-20 mg/day, n = 331) in elderly patients aged more than 60 years old. The risk ratio for group S compared with group L was 0.674(95% confidence interval: 0.423-1.074). The Japan Lipid Intervention Trial(J-LIT) is the first nation-wide study conducted to determine a relationship between serum lipid concentrations and the development of CHD under simvastatin treatment. The J-LIT study enrolled 52,421 men and women with total cholesterol(TC) more than 220 mg/dl. Patients were treated with open-labeled simvastatin at a dose of 5 to 10 mg/day for 6 years. Simvastatin reduced serum concentrations of TC, LDL-C and TG by 18.4, 26.8 and 16.1%, respectively. LDL-C positively correlated with the CHD events and the relative risk of CHD was higher significantly more than 160 mg/dl of LDL-C.