Helsinki Heart Study. New perspectives in the prevention of coronary heart disease.
The Helsinki Heart Study tested the effect of modifying plasma low density lipoprotein (LDL)- and high density lipoprotein (HDL)-cholesterol on the primary prevention of coronary heart disease in middle-aged men with non-HDL-cholesterol greater than or equal to 5.2 mmol/L (200 mg/dl). One group (2046 men) received 600mg of gemfibrozil twice daily, and the other (2035 men) received placebo. Averaged over the 5-year trial period, gemfibrozil induced mean decreases of 11% in LDL-cholesterol and 35% in triglycerides and a mean increase of 11% in HDL-cholesterol compared with placebo. These changes were accompanied by a 34% reduction (number of end-points; 56 vs 84) in the incidence of coronary heart disease. The reduction was largest in subjects with type IIB hyperlipoproteinaemia and smallest in subjects with type IIA hyperlipoproteinaemia. The changes in serum HDL- and LDL-cholesterol during the trial were associated (p less than 0.02 and p less than 0.05, respectively) with the risk of coronary heart disease in the gemfibrozil group, but not in the placebo group.
Huttunen
J K
JK
First Department of Medicine, University of Helsinki, Finland.
Frick
M H
MH
Heinonen
O P
OP
Heinsalmi
P
P
Manninen
V
V
Mänttäri
M
M
Romo
M
M
D000328:Adult; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000517:prevention & control*; D004311:Double-Blind Method; D005387:Finland; D015248:Gemfibrozil / Q000627:therapeutic use*; D006801:Humans; D006951:Hyperlipoproteinemias / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D011897:Random Allocation
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D015248:Gemfibrozil