Effects of colestipol, clofibrate, and placebo on plasma lipoproteins of patients with hypercholesterolemia

To evaluate the effectiveness of colestipol and clofibrate in patients with hypercholesterolemia and normal concentrations of triglycerides, 27 patients were randomized into three groups, and colestipol, clofibrate, and avicel powder placebo were compared for effects on concentration of total plasma lipid and lipoprotein cholesterol and triglyceride in a single blind protocol over 8 mo. Mean pretreatment values for low density lipoprotein (LDL)-cholesterol and very low density lipoprotein (VLDL) triglyceride were 250 mg/dl and 68 mg/dl, respectively. Colestipol (30 g/day) lowered total- and LDL-cholesterol by 25% and 31%, respectively, while VLDL-triglyceride rose. Overall clofibrate lowered total- and LDL-cholesterol by 13% and 12% while lowering VLDL-triglyceride 21% and VLDL cholesterol by 50%. For clofibrate, certain patients showed a more pronounced effect than others: in seven of nine patients clofibrate lowered both mean total- and LDL-cholesterol by 17% (range 8% to 31%) and 19% (range 10%-44%) respectively, whereas two patients did not respond to clofibrate. High density lipoproteins were not affected by either colestipol or clofibrate in these patients. Thus, while colestipol was more consistently effective, certain hypercholesterolemic patients responded equally well to clofibrate with substantial lowering of total-, LDL-, and VLDL-cholesterol.