Mellat Park, Vali Asr Avenue, Tehran, Iran


Background- Coronary artery disease (CAD) is the most common cause of mortality in industrial countries. Many risk factors are recognized for predisposing of atherosclerosis in coronary arteries. An the control of risk factors are the basis of primary and secondary prevention, this study has been done for diagnosis and management of hyperlipidemia as one of major risk factors for CAD.
Methods and Results- Among 3000 patients who were referred to Rajai Heart Center’s risk factor clinic during 1996-1998, 528 patients were selected randomly. 485 patients (92%) had hyperlipidemia of whom nearly 79% had type II hyperlipidemia. There was no significant statistical relation between age and level of hyperlipidemia. The effect of gender on hyperlipidemia was seen in HDL (high density lipoprotein) among the 40-49 year age group. All of the patients were put on diet therapy for 2 months and if there was no response, therapy with fluvastatin, cholestyramine, gemfibrozil or a combination of two was initiated. The fluvastatin group showed a reduction of cholesterol, triglycerides (TG) and low density lipoprotein (LDL) by 17.2%, 9% and 23.7% respectively, and an increase of 7.4% in HDL level. Gemfibrozil induced a reduction of cholesterol and TG by 12% and 46.9% and cholestyramine caused a reduction of 10 % and 14.7% in cholesterol and TG and increase of 10% in HDL. The best response to therapy was seen in a combination of fluvastatin and gemfibrozil, in type IIb hyperlipidemia.
Conclusions- Response to diet therapy was lesser than other countries. The response to gemfibrozil was similar to other studies and response to a combination of gemfibrozil and fluvastatin were prominent