Effect of pravastatin and cholestyramine on triglyceride-rich lipoprotein particles and Lp(a) in patients with type II hypercholesterolemia

The effects of treatment, on plasma lipids in patients with Type II hypercholesterolemia, for 8–24 weeks was determined with pravastatin (PR) and cholestyramine (CH) given alone or in combination. The first 8 weeks of treatment included a parallel placebo (P) control, while the subsequent period to 24 weeks compared four groups (40 and 80 mg PR, CH, and PR + CH). There were seven to nine patients per group (average age of 58 years). Cholesterol (C) and low-density lipoprotein cholesterol (LDL-C) decreased with PR and CH. There were inconsistent and nonsignificant effects on triglycerides and high-density lipoprotein cholesterol (HDL-C). Apolipoproteins A-I, A-II, B, and Lp(a) were measured, and only Apo-B decreased with drug therapy. Lipoprotein particles characterized by their specific apolipoprotein content were also measured. LpB Cholesterol ester-rich, containing predominantly Apo-B, decreased with PR and CH relative to their respective baselines, but not relative to P. Similarly, triglyceride-rich, LpBc, a complex lipoprotein particle containing apolipoproteins A-I, A-II, B, C, D, and E decreased relative to baseline, but not with respect to P. This study has further defined the effect of PR and CH on lipids and lipoprotein particles in patients with Type II hypercholesterolemia. These effects might be favorable in relation to reduction of risk factors in atherosclerosis.