Effects of Simvastatin Alone or in Combination With Continuous Combined Hormone Replacement Therapy on Serum Lipid Levels in Hypercholesterolemic Postmenopausal Women

Purpose: To evaluate the effects of simvastatin alone or together with continuous combined hormone replacement therapy on the serum lipid profile in hypercholesterolemic postmenopausal wowen. Patients and Methods: One hundred hypercholesterolemic postmenopausal women were stratified to one of the two treatment arms; simvastatin 10 mg daily together with estrogen 0.625 mg and medroxyprogesterone 2.5 mg daily (group A) (n: 50) or simvastatin 10 mg daily (group B) (n:50). Serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol and triglyceride levels were measured at baseline, at 3 and 6 months; and laboratory and elinical evidence of adverse events were monitored periodically throughout the study. Results: The initial mean (± SD) cholesterol values were as follows for groups A and B, respectively: total cholesterol 240.0±28.0 and 248.9±28.2 mg/di; LDL-cholesterol 174.7±25.6 and 1 75.1±25.9; HDL cholesterol 37.2±5.0 and 39.9±9.7.3 mg/d!. Compared with the baseline, total and LDL cholesterol levels decreased; and HDL cholesterol levels increased significantly at 3 and 6 months in both groups. However, the mean percent reduction in total cholesterol anad LDL~cholesterol was significantly greater in group A compared with group B both at 3 months (12.3±7.0% vs 8.9±6.2 %; p<0.01; and 19.0±10.6% vs 13.2±10.4 %; p<0.005, respectively) and at 6 months (14.6±7.7 % vs 1 1.3±7.4 %; p<0.05 and 23.3±9.7 % vs 15.8±12.3 %; p<0.005, respectively). The mean percent increase in serum HDL-cholesterol concentrations was also significantly greater in group A compared with group B at both times (14.6±1 1.8 % vs 9.8±1 1.8 %; p<0.005, at 3 months, and 21.3±15.2% vs l 1.1±12.5; p<0.005, at 6 months, respectively). Furthermore, significantly more patients in group A than in group B attained their target treatment goals dictated by the NCEP guidelines. Although the mean percent decrease in triglyceride levels was significantly greater in group in group A at 3 months, the significance disappeared at 6 months. Conclusion: The combination of simvastatin and continuous combined hormone replacement therapy seems to be more effective than sirnvastatin alone in the treatment of hypercholesterolemia in postmenopausal women.