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Effects of policosanol on older patients with hypertension and type II hypercholesterolaemia
Gladys Castaño1, Rosa Más, Julio C Fernández
1Surgical Medical Research Center, Havana City, Cuba.
Insights
Policosanol effectively lowers LDL cholesterol and triglycerides while raising HDL cholesterol in older adults with hypertension and high cholesterol. This 12-month study also showed reduced adverse events and blood pressure in policosanol recipients.
Area of Science:
- Cardiovascular Health
- Lipid Metabolism
- Geriatric Medicine
Background:
- Older adults with hypertension and type II hypercholesterolaemia are at increased risk for cardiovascular events.
- Effective lipid management is crucial for this patient population, especially those without a history of coronary heart disease (CHD) or cerebrovascular disease.
Purpose of the Study:
- To investigate the long-term effects of policosanol on lipid profiles in older patients with hypertension and type II hypercholesterolaemia.
- To assess the safety and efficacy of policosanol in this specific demographic over a 12-month period.
Main Methods:
- A prospective, randomized, double-blind, placebo-controlled study involving 589 older patients.
- Patients received either policosanol (5-10 mg/day) or a placebo for 12 months, following a cholesterol-lowering diet.
- Dosage adjustments were made based on total cholesterol levels after 6 months.
Main Results:
- Policosanol significantly reduced LDL-C (20.5%), total cholesterol (15.4%), triglycerides (11.9%), and LDL-C/HDL-C ratio (22.2%), while increasing HDL-C (12.7%).
- Serious adverse events (SAEs) and total adverse events (AEs) were significantly lower in the policosanol group compared to placebo.
- Policosanol also led to a significant reduction in systolic blood pressure.
Conclusions:
- Long-term policosanol administration is effective in improving lipid profiles (lowering LDL-C and TC, increasing HDL-C) in older patients with hypertension and hypercholesterolaemia.
- Policosanol treatment demonstrated benefits in reducing vascular SAEs, improving the overall AE profile, and lowering blood pressure.
Objective:
This study was conducted to investigate the effects of policosanol administered for 12 months on the lipid profile of older patients with hypertension and type II hypercholesterolaemia and no history of coronary heart disease (CHD) or cerebrovascular disease.
Patients And Participants:
589 older male and female patients with hypertension and type II hypercholesterolaemia and no history of CHD or cerebrovascular disease were included.
Methods:
This was a prospective, randomised, double-blind, placebo-controlled study in parallel groups treated with policosanol (5 to 10 mg/day) for 1 year. After 6 weeks on a standard step I cholesterol-lowering diet, 589 patients were randomised to policosanol (5 mg) or placebo tablets, to be taken once daily for 12 months. The dosage was doubled to 10 mg/day if total cholesterol values were > 6.1 mmol/L after 6 months of therapy.
Results:
Policosanol significantly (p < 0.00001) lowered serum low-density lipoprotein-cholesterol (LDL-C) [20.5%], total cholesterol (TC) [15.4%], triglycerides (11.9%), LDL-C/high-density lipoprotein-cholesterol (HDL-C) ratio [22.2%] and TC/HDL-C ratio (20.1%), and increased (p < 0.0001) HDL-C (12.7%). The frequency of vascular and all-cause serious adverse events (SAEs) was lower (p < 0.05) in the policosanol recipients (two vascular SAEs, 0.7%; five all-cause SAEs, 1.7%) than in the placebo recipients (six vascular SAEs, 2.0%; 12 all-cause SAEs, 4.1%). Similarly, total adverse events (AEs) were less frequent in the policosanol-treated group (29; 9.8%) compared with the placebo group (52; 17.7%) [p < 0.01]. Three placebo recipients and no policosanol recipents died during the study as a result of myocardial infarction (two patients) and sudden cardiac arrest (one). Policosanol was well tolerated, and no drug-related disturbances in safety indicators were found. Policosanol significantly decreased systolic blood pressure (BP) compared with baseline and placebo, which could be an additional advantage in this population at high coronary risk.
Conclusions:
Policosanol administered long term is effective in lowering LDL-C and TC as well as increasing HDL-C levels in older patients with hypertension and type II hypercholesterolaemia without a history of CHD or cerebrovascular disease. In addition, policosanol treatment also shows benefits in the occurrence of SAEs of vascular aetiology, on the general AE profile and the reduction of BP in treated patients compared with baseline.