ABSTRACT

 Background: Hyperlipidemia is a known risk factor for cardiovascular disease. Statins therapy greatly reduce the risk of cardiovascular events. The rationale of this study was to investigate the effectiveness of Atorvastatin (20mg vs. 40mg) in lowering LDL-C levels.

Aim: To determine the effectiveness of Atorvastatin (Low vs. High Dose) in terms of lowering LDL to < 100mg/dl in patients with Intermediate risk of cardiovascular disease by Framingham risk score.

Methodology: It was a randomized controlled trial and 140 patients, previously on no lipid lowering therapy, were divided into two groups by lottery method. This study was completed in 6 months after it was approved from IRB/ASRB.Baseline LDL cholesterol levels were recorded. One group was given low dose (20mg) atorvastatin while other was given high dose (40mg) atorvastatin for 6 months. LDL levels were again monitored after 6 months and efficacy of treatment was assessed.

Results: The mean age of the patients in group 1 was 61.67 years (SD 9.84) and group 2 was 66.7 years (SD 8.78), mean LDL-C levels were 149.24 mg/dl (SD 27.767). In group 1, 62.9% were males and 37.1% were females, whereas in group 2, 65.7% were males and 34.3% were females. Family history of cardiovascular disease was present in 61% of the patients, 41.43% were smokers, 59.3% were hypertensive and 45% were Diabetic. Chi square test revealed that both therapies had significant effect on lowering LDL-cholesterol and were equally effective.

Conclusion: Low dose Atorvastatin to reduce the LDL-C levels in Intermediate risk patients is equally effective and can help to get the same benefit from low dose preventing the side effects of high dose.

Key words: Cardiovascular disease, low density lipoprotein cholesterol, atorvastatin