PHARMACOTHERAPY REVIEW CNS STIMULANTS for treatment of ...

CARE(The Cholesterol and Recurrent Events Trial)• Double-blind trial, 4159 patients (3583 men and 576 women), Pravastatin 40mg/day• The patients had history of MI with cholesterol less than 240, and LDL levels averaging 115to 174.• The primary end point was fatal coronary event or nonfatal MI, the frequency of the endpoint was 10.2% in the pravastatin group and 13.2% in the placebo group, with yielded a24% risk reduction.• The frequency of stroke was reduced by 31%. The incidence of stroke was 3.8% in theplacebo group and 2.6 in the pravastatin group.• Pravastatin lowered the rate of coronary events more among women than men.• The reduction in coronary events was also greater in patients with higher pretreatment levelsof LDL.• These results show that the benefit of cholesterol lowering therapy extends to the majority ofpatients with coronary disease who have average cholesterol levels.• Patients with LDL greater than 175 had dietary counseling, and if the LDL stayed above 175,cholestyramine was prescribed in daily doses of 8 to16grams.• Pravastatin lowered the mean LDL cholesterol by 32% and these levels were maintainedthroughout the 5-year follow-up.• The higher the LDL the greater the risk reduction found when using pravastatin• There were 45 deaths due to cancer in the placebo group and 49 in the pravastatin group.• Breast cancer occurred in 1 patient in the placebo group and 12 in the pravastatin group. Thepatient in the placebo group had history of breast cancer, and 3 of the 12 had history of breastCA.• Overall in the general population in treating 1000 of such patients, 150 cardiovascular eventscould be prevented, 51 patients would be spared from having one event. If the 1000 patientswere at higher risk or women then the benefit would be greater.18