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The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), a large randomized trial of different initial blood pressure pharmacological therapies, found no large differences between initial therapy with a chlorthalidone, amlodipine and lisinopril.
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The Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial was designed to study the effects of long-term, intensive cholesterol lowering with daily use of simvastatin and ezetimibe on clinical and echocardiographic outcomes in patients with asymptomatic, mild-to-moderate aortic-valve stenosis and no other indication for lipid-lowering treatment.
It has been shown to result in lower risk of events, albeit in a select group of patients, and further trial data are awaited with regard to its effect on cardiovascular end points.
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During ezetimibe treatment, there is a marked compensatory increase in synthesis in the liver, but not in the peripheral organs, and an accelerated loss of cholesterol in the feces with little or change in the rate of conversion of cholesterol to bile acids.
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Eighteen healthy vegetarian subjects (14 women and 4 men) were recruited for this trial.
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Treatment should be based on fasting lipid levels (mainly LDL) obtained after glucose control is established.
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Open-label lipid-lowering therapy, which included up to 40 mg of simvastatin or an equipotent dose of another lipid-lowering drug, could be administered in addition to the study drug at the discretion of each treating physician, although patients and investigators remained unaware of study-group assignments.
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