Effect of fluvastatin in combination with moderate endurance training on parameters of lipid metabolism.
OBJECTIVE
To establish whether patients receiving the cholesterol synthesis enzyme inhibitor fluvastatin 20 mg/day could obtain an additional improvement in their lipid pattern as a result of physical endurance training.


METHODS
This was an observational study using a before- and after-treatment comparison of fitness and lipid parameters in outpatients with dyslipidaemia who undertook an exercise programme with or without treatment with a lipid-lowering drug.


METHODS
Participants were 18 sedentary [maximum oxygen uptake (VO2max) < 30 ml/kg bodyweight per minute] men (age range 38 to 65 years) with dyslipidaemia but without overt cardiovascular disease.


METHODS
All participants undertook a 1-hour bout of endurance training twice a week for 3 months. The training involved a circuit using various ergometers, with continuous monitoring of pulse rate, at an exercise intensity of 2 to 3 mmol/L lactate. The control group (n = 6) received no drug treatment; they completed the training programme only. The pretreatment group (n = 6) comprised participants who had already been treated with fluvastatin 20 mg/day for at least 3 months before beginning the training programme. The treatment group (n = 6) received fluvastatin 20 mg/day from the beginning of the training programme. All participants were required to comply with the exercise programme and with a standardised carbohydrate-loaded diet together with restriction of alcohol consumption to a maximum of 20 ml/day.


RESULTS
In the control group, increased physical activity alone reduced serum triglyceride (TG) levels (-24.7%) and increased serum high density lipoprotein-cholesterol (HDL-C) levels (+19.3%). There was a smaller effect on serum low density lipoprotein-cholesterol (LDL-C) levels (-12.8%). Similar but smaller effects were observed in the pretreatment group (i.e. patients previously treated with fluvastatin): TG -12.88%, HDL-C +13.81%, LDL-C -8.7%. Marked changes were observed in the treatment group: TG -33.1%, HDL-C +34.7%, LDL-C -40.5%, total cholesterol -30.5%.


CONCLUSIONS
A reduction of serum LDL-C level in the target range of -30 to -40% cannot be achieved by this intensity of training alone. In combination with fluvastatin 20 mg/day, however, the positive effects on lipid metabolism are potentiated. Thus, treatment with fluvastatin combined with moderate endurance training is a rational mode of therapy, particularly in patients with a highly pathological lipid profile.
Wittke
R
R
Sports Medicine Institute, Bayreuth, Germany.
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage*; D005260:Female; D000077340:Fluvastatin; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D006949:Hyperlipidemias / Q000175:diagnosis / Q000628:therapy*; D007211:Indoles / Q000008:administration & dosage*; D008075:Lipoproteins, HDL / Q000187:drug effects / Q000378:metabolism*; D008077:Lipoproteins, LDL / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology*; D012016:Reference Values; D016896:Treatment Outcome
D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D000077340:Fluvastatin