Purpose: HMG-CoA reductase inhibitors (statins) have been widely used in the treatment of hypercholesteremia in Japan as well as in Western countries. Although statins have been shown to be effective in the prevention of coronary heart disease (CHD) in high-risk patients, the potential benefit of statins on the overall mortality has not been proven in subjects at lower risk for CHD. In this study, we investigated the risk factors and serum cholesterol concentrations in patients given pravastatin.
Methods: Patients who were given pravastatin during the period from June 2002 until May 2003 in the Hamamatsu University Hospital were studied. Data for height, body weight, age, gender, smoking and history of diabetes mellitus, hypertension and CHD in the patients were collected from their case records. Serum cholesterol concentrations were determined before and after the treatment with pravastatin. The ethics committee in the Hamamatsu University approved this study.
Results: There were 213 male (37.4%) and 356 female (62.6%) patients given pravastatin. The mean age of the patients was 63.9 yrs, and % of the patients aged under 50 yrs was 10.7%. Seventy-seven % of the patients had no history of CHD. Female patients without smoking, diabetes mellitus, hypertension and CHD constituted 17% of all patients. Total and LDL cholesterol levels in all groups were significantly decreased by 17.6% and 25.5%, respectively, after the administration of pravastatin. Treatment with pravastatin was started at the lower total cholesterol levels in male patients or patients with CHD than in female patients or patients without CHD.
Conclusion:Our results suggest that significant numbers of patients with a low risk for CHD were prescribed the statins, and that placebo-controlled large-scale trials should be conducted to demonstrate the benefit and safety of statin treatment on overall mortality in Japan.
