title: Diet and exercise and gemfibrozil therapy for the management of dyslipidemia: a CEN study. Clinical Experience Network.
abstract: BACKGROUND
  Dyslipidemia constitutes a serious health problem that should be diagnosed and treated by the family physician. Little is known about the efficacy of typical dietary therapy for patients with abnormal cholesterol levels. This study was the first large prospective family practice evaluation of the effectiveness of diet-and-exercise therapy followed by a pharmacologic intervention for those patients who remained dyslipidemic.
  
  
  METHODS
  Patients who met standard criteria for cardiovascular disease risk based on lipid analysis were enrolled in a typical 6-week physician-directed diet-and-exercise program. Those patients who were still dyslipidemic after that period were started on 12 weeks of pharmacologic treatment with gemfibrozil.
  
  
  RESULTS
  Of the 2992 patients screened, 1193 were eligible for participation in the study. The diet-and-exercise program led to a modest change in lipid values (average decrease in total cholesterol of 4.1%). Only 2% of the patients achieved desirable levels of all lipid values. Seven hundred thirty-nine subjects qualified for further therapy and were treated with gemfibrozil. Seventy patients discontinued drug therapy because of adverse effects. Those who completed 12 weeks of pharmacologic therapy had an additional 5.4% reduction in total cholesterol, 3.9% reduction in low-density lipoprotein cholesterol, 30.6% reduction in triglycerides, and a 17.2% increase in high-density lipoprotein cholesterol.
  
  
  CONCLUSIONS
  These findings suggest that in a typical clinical setting, a nonpharmacologic intervention of diet and exercise may not produce the desired overall lipid changes in the majority of dyslipidemic patients.
authors: School of Medicine, University of Missouri, Kansas City.
authors: W J
authors: WJ
authors: Stelmach
authors: D R
authors: DR
authors: Rush
authors: P C
authors: PC
authors: Brucker
authors: E J
authors: EJ
authors: Schaefer
authors: H E
authors: HE
authors: Holverson
authors: W J
authors: WJ
authors: Kane
authors: B L
authors: BL
authors: Huffman
mesh_terms: D002784:Cholesterol / Q000097:blood; D003131:Combined Modality Therapy; D004041:Dietary Fats / Q000008:administration & dosage*; D015444:Exercise; D005194:Family Practice; D005260:Female; D015248:Gemfibrozil / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D014481:United States
chemical_list: D004041:Dietary Fats; D014280:Triglycerides; D002784:Cholesterol; D015248:Gemfibrozil