Abstract
Background: Some reports suggest that atorvastatin is more effective than other statins in decreasing serum triglyceride (TG) levels in patients with hypercholesterolemia. Objective: The aim of this study is to compare the hypotriglyceridemic activity of atorvastatin and simvastatin at doses that elicit similar hypocholesterolemic effects. Methods: Outpatients with primary hypercholesterolemia that was not adequately controlled with a stable low-fat, low-cholesterol diet were randomized to 1 of 2 treatments: atorvastatin 10 mg daily (n = 100) or simvastatin 20 mg daily (n = 100) for up to 6 months. Serum TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured at baseline and after 2 and 6 months of therapy. Results: After 2 months of therapy, serum TG, TC, and LDL-C levels significantly decreased ( P < 0.001) and HDL-C levels significantly increased ( P < 0.01) in both treatment groups compared with baseline values. The percentage changes in serum TG, TC, and LDL-C levels were similar, whereas the percentage increase in HDL-C level was greater in the simvastatin group than in the atorvastatin group. In both groups of patients, the decrease in serum TG level was correlated with baseline serum TG levels; patients with high baseline serum TG levels had a greater hypotriglyceridemic response than patients with low baseline serum TG levels. After adjusting for the error due to regression to the mean, the difference in hypotriglyceridemic response between patients with high and those with low pretreatment serum TG levels decreased in both treatment groups. Conclusions: In patients with hypercholesterolemia, atorvastatin 10 mg/d and simvastatin 20 mg/d had similar effects on serum TG, TC, and LDL-C levels. Both drugs increased HDL-C levels, but the effect of simvastatin was significantly greater than that of atorvastatin.
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