Effect of Pravastatin, Cholestyramine or their Combination in the Treatment of Hypercholesterolaemia in Elderly Hypertensive Patients

30 elderly patients (27 male, 3 female) with treated essential hypertension entered a crossover factorial study to determine the effectiveness of pravastatin (10 and 20 mg/day), cholestyramine (4 or 8 g/day) or their combination in the treatment of hypercholesterolaemia (serum cholesterol 5.5 to 7.5 mmol/L). Pravastatin was well tolerated, but significant dose-related adverse effects were observed with cholestyramine (30% with 8 g/day). Both drugs lowered cholesterol and low density lipoprotein (LDL) cholesterol and caused small rises in high density lipoprotein (HDL) cholesterol, leading to improvement in the various calculated ratios. Triglycerides fell with pravastatin but were not altered by cholestyramine. Approximately 75% or more of the total fall in cholesterol was achieved with the lower dose of both drugs. The combination of the 2 drugs was more effective than either drug alone and the combination of the 2 lower doses was more effective than the higher dose of either drug. Thus, this study infers that the use of low doses of the 2 drugs is a more effective way to reduce cholesterol than progressing to higher drug doses.