title: Cholesterol-lowering drugs. Some drugs with demonstrated efficacy but different benefits in primary and secondary prevention.
abstract: (1) In primary prevention trials, pravastatin and lovastatin prevented myocardial infarction and had a positive risk-benefit ratio in men with LDL-cholesterol values exceeding 4.5 mmol/l (1.7 g/l).  Cholestyramine and gemfibrozil also prevented myocardial infarction in men with more severe hypercholesterolaemia; while clofibrate had a negative risk-benefit ratio in patients with moderate hypercholesterolaemia. These treatments have not been assessed for primary prevention in women or in patients aged over 70.  (2) In trials involving patients with coronary heart disease, pravastatin and simvastatin both reduced the risk of myocardial infarction and/or mortality in patients of both sexes with LDL-cholesterol values above 3.2 mmol/l (1.2 g/l).  Gemfibrozil also reduced the risk of myocardial infarction but not mortality, while clofibrate and bezafibrate had no preventive effect.
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001629:Bezafibrate; D002792:Cholestyramine Resin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D002994:Clofibrate; D005260:Female; D015248:Gemfibrozil / Q000627:therapeutic use; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000401:mortality; D008148:Lovastatin / Q000627:therapeutic use; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy / Q000517:prevention & control*; D017035:Pravastatin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D002792:Cholestyramine Resin; D008148:Lovastatin; D002994:Clofibrate; D017035:Pravastatin; D015248:Gemfibrozil; D001629:Bezafibrate