Guar gum and gemfibrozil - an effective combination in the treatment of hypercholesterolaemia

Abstract

Twenty-nine hypercholesterolaemic patients, treated for one year with gemfibrozil but being still hypercholesterolaemic (serum total cholesterol _ ̌ 6.25 mmol/1) were included in a double-blind trial to evaluate the hypocholesterolaemic effects of gemfibrozil-guar gum combination (GE + GU) vs. gemfibrozil-placebo combination (GE + PL) using a cross-over study design. The patients were treated with gemfibrozil on a constant dosage (range 900-1200 mg/day) during the entire trial. After a 4-week run-in period on GE + PL treatment the patients were randomly allocated to 2 groups: one received GE + GU 15 g/day, and the other GE + PL for 3 months and after that groups were crossed over. Guar gum and placebo were administered as granules taken 3 times a day during meals. Serum total cholesterol was 8.61 ± 0.17 mmol/1 before gemfibrozil therapy, and 7.29 ± 0.15 mmol/1 at the end of the run-in period on GE + PL (P < 0.01). During the double-blind phase serum total cholesterol values were 6.28 ± 0.19 mmol/1 at the end of the GE + GU treatment period and 7.21 ± 0.16 mmol/l at the end of the GE + PL treatment period (P < 0.01). At the end of the GE + GU treatment period serum total cholesterol was 27% lower and LDL-cholesterol 39% lower than before gemfibrozil treatment. A marked improvement (23%) was found in HDL/LDL ratio during GE + GU treatment compared with GE + PL treatment. The HDL/LDL ratio was remarkably higher (95%) at the end of GE + GU treatment than before gemfibrozil. It is concluded that combination therapy with gemfibrozil and guar gum is effective in lowering elevated serum total and LDL cholesterol levels and in particular in increasing HDL/LDL ratio. © 1989.