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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 37 (1989), S. 199-203 
    ISSN: 1432-1041
    Keywords: simvastatin ; fenofibrate ; hypercholesterolaemia ; apolipoproteins ; lipoproteins ; adverse effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Sixteen patients with primary hypercholesterolaemia received double-blind either fenofibrate (n=8; 200 mg bid) or the HMG-CoA reductase inhibitor simvastatin (n=8; 20 mg qid or 40 mg qid if LDL-cholesterol did not fall below 3.6 mmol·l−1 after 4 weeks of treatment). Simvastatin reduced total cholesterol from 9.7 to 7.0 mmol·l−1 after 10 weeks (−28%), and fenofibrate reduced it from 9.2 to 7.7 mmol·l−1 (−15%). The decrease was less during fenofibrate than during simvastatin treatment (time × drug:p=0.02). Serum LDL-cholesterol fell from 8.3 to 5.3 mmol·l−1 (−36%) during simvastatin and from 7.2 to 6.0 mmol·l−1 (−16%) during fenofibrate administration. Again, the effect of simvastatin was more pronounced than that of fenofibrate (time × drug:p=0.03). HDL-cholesterol increased significantly from 1.1 to 1.2 mmol·l−1 (+13%) during fenofibrate administration and it did not change significantly during simvastatin. Serum triglycerides fell from 1.3 to 1.1 mmol·l−1 (−16%) during simvastatin, and even more significantly from 2.2 to 1.1 mmol·l−1 (−51%) during fenofibrate (time × drug:p=0.002). Apolipoprotein B fell on simvastatin from 1.9 to 1.4 g·l−1 (−24%) and from 1.8 to 1.4 g·l−1 (−22%) during fenofibrate. Both drugs were well tolerated and had no significant adverse effects. Simvastatin lowered total and LDL-cholesterol concentrations more than fenofibrate, while the latter had more effect on triglycerides, suggesting specific indications for the two drugs in the treatment of hyperlipoproteinaemias.
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  • 2
    ISSN: 1432-1041
    Keywords: Insulin ; Fosinopril ; insulin sensitivity ; glucose tolerance ; lipoproteins ; ACE inhibition ; normal humans ; blood pressure ; adverse effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effect of the new ACE-inhibitor, fosinopril, on insulin sensitivity (SI), glucose homoeostasis and lipid profile has been examined in 24 young, healthy, normotensive men. SI, fasting plasma glucose and insulin, serum total triglycerides (Tg) and lipoprotein cholesterol (C) fractions, and ACE activity were assessed after subjects had taken placebo for 1 week and after 3 further weeks either on placebo (12 subjects) or fosinopril 20 mg daily (12 subjects), administered in a doubleblind, randomized order. Measurements were made after 3 days on a standard diet (2500 kcal/d, 45% carbohydrates, 40% fat and 15% proteins) and after an over-night fast. Compared with control values at the end of the runin placebo phase, fosinopril reduced plasma ACE activity (from 106 to 24 nmol·ml−1·min−1), Significantly increased plasma potassium and lowered upright systolic blood pressure. It also improved the k-value of the glucose disappearance rate after glucose load (from −1.70 to −1.88%·min−1) and tended to increase SI slightly although not significantly (from 10.2 to 12.0·10−4·min−1·μU−1·ml−1). Fasting plasma glucose, insulin, serum total, high-, low-, and very-low density lipoprotein cholesterol fractions and total triglycerides were unchanged following fosinopril and placebo. The findings indicate that in healthy lean humans, ACE inhibition with fosinopril is neutral with regard to lipoprotein and carbohydrate metabolism, and that it may slightly enhance cellular glucose disposal. This calls for further evaluation in individuals at high risk of developing insulin resistance and in patients with impaired insulin sensitivity related to hypertension, obesity, decreased glucose tolerance and diabetes mellitus.
    Type of Medium: Electronic Resource
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