Psyllium as Effective as a Double Dose of Simvastatin in Lowering LDL Cholestero

Psyllium supplements three times a day plus simvastatin 10 mg once a day are as effective as simvastatin 20 mg daily for patients who are candidates for lipid-lowering therapy Dr. Abel E. Moreyra presented the 8-week findings of a trial of 67 patients with baseline LDL cholesterol levels between 161 and 186 mg/dL. After 4 weeks off all lipid-lowering therapy, patients were randomized to simvastatin 20 mg qd plus placebo (Tang), simvastatin 10 mg qd plus placebo or simvastatin 10 mg qd plus 5 g psyllium (Metamucil) three times a day, taken in at least 8 ounces of water. LDL cholesterol, HDL cholesterol, triglycerides and apoproteins A-1 and B were measured.

Dr. Moreyra said that psyllium plus 10 mg simvastatin was "as effective in lowering LDL cholesterol and ApoB as 20 mg simvastatin alone."

LDL cholesterol levels dropped 63 mg/dL (29%) in the 20-mg simvastatin group and the 10-mg simvastatin plus psyllium group over the 8-week study period, while LDL levels dropped 55 mg/dL in the 10-mg simvastatin group.

ApoB lipoprotein dropped 46 micrograms/mL in the high-dose statin-only group and 50 micrograms/mL in the fiber plus statin group. The effect on HDL cholesterol was negligible in all three groups.

"Patients are concerned with the side effects of statins," Dr. Moreyra noted, and they are likely reluctant to take a double dose of the drug. Psyllium is safe, readily available and the treatment is effective and practical, he added.

American Heart Association’s Scientific Sessions 2004.