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Guar gum and gemfibrozil--an effective combination in the treatment of hypercholesterolaemia
J Tuomilehto1, M Silvasti, V Manninen
1National Public Health Institute, Department of Epidemiology, Helsinki, Finland.
Insights
Adding guar gum to gemfibrozil significantly lowered cholesterol levels in hypercholesterolaemic patients. This combination therapy improved lipid profiles, offering a potential adjunctive treatment for managing high cholesterol.
Area of Science:
- Cardiology
- Nutritional Science
- Pharmacology
Background:
- Hypercholesterolaemia remains a significant risk factor for cardiovascular disease.
- Gemfibrozil is a commonly prescribed lipid-lowering agent.
- Persistent hypercholesterolaemia despite gemfibrozil treatment necessitates exploring adjunctive therapies.
Purpose of the Study:
- To evaluate the hypocholesterolaemic effects of combining gemfibrozil with guar gum.
- To compare the efficacy of gemfibrozil-guar gum versus gemfibrozil-placebo in hypercholesterolaemic patients.
Main Methods:
- A double-blind, cross-over study design was employed.
- Twenty-nine patients with persistent hypercholesterolaemia on gemfibrozil were included.
- Patients received either gemfibrozil-guar gum or gemfibrozil-placebo for 3-month periods.
Main Results:
- Gemfibrozil-guar gum significantly reduced serum total cholesterol by 27% and LDL-cholesterol by 39% compared to baseline.
- The gemfibrozil-guar gum combination showed a significant decrease in total cholesterol compared to gemfibrozil-placebo.
- A 23% improvement in the HDL/LDL ratio was observed with gemfibrozil-guar gum treatment.
Conclusions:
- Guar gum, when combined with gemfibrozil, demonstrates significant hypocholesterolaemic effects.
- The gemfibrozil-guar gum combination offers an effective strategy for further reducing cholesterol in patients inadequately managed by gemfibrozil alone.
- This combination therapy may improve overall lipid profiles and potentially reduce cardiovascular risk.
Abstract:
Twenty-nine hypercholesterolaemic patients, treated for one year with gemfibrozil but being still hypercholesterolaemic (serum total cholesterol greater than or equal to 6.25 mmol/l) were included in a double-blind trial to evaluate the hypocholesterolaemic effects of gemfibrozil-guar gum combination (GE + GU) vs. gemfibrozil-placebo combination (GE + PL) using a cross-over study design. The patients were treated with gemfibrozil on a constant dosage (range 900-1200 mg/day) during the entire trial. After a 4-week run-in period on GE + PL treatment the patients were randomly allocated to 2 groups: one received GE + GU 15 g/day, and the other GE + PL for 3 months and after that groups were crossed over. Guar gum and placebo were administered as granules taken 3 times a day during meals. Serum total cholesterol was 8.61 +/- 0.17 mmol/l before gemfibrozil therapy, and 7.29 +/- 0.15 mmol/l at the end of the run-in period on GE + PL (P less than 0.01). During the double-blind phase serum total cholesterol values were 6.28 +/- 0.19 mmol/l at the end of the GE + GU treatment period and 7.21 +/- 0.16 mmol/l at the end of the GE + PL treatment period (P less than 0.01). At the end of the GE + GU treatment period serum total cholesterol was 27% lower and LDL-cholesterol 39% lower than before gemfibrozil treatment. A marked improvement (23%) was found in HDL/LDL ratio during GE + GU treatment compared with GE + PL treatment.(ABSTRACT TRUNCATED AT 250 WORDS)