Effects of Low‐Dose Pravastatin on Plasma Levels of Lipids and Apolipoproteins in Japanese Type II Hyperlipoproteinemic Subjects with Apolipoprotein E Phenotype E3/2, E3/3, and E4/3

Effects of 12 weeks of treatment with pravastatin at a dose of 20 mg/day were compared in subjects with type II hyperlipoproteinemia with apo+(lipoprotein) E phenotype E3/2, E3/3, and E4/3. There were no differences in age, body mass index, smoking status, complications, or plasma levels of lipids and apoproteins, except the higher levels of apo E in E3/2 subjects (n = 11) than in E3/3 subjects (n = 84) and E4/3 subjects (n = 28). Plasma levels of low‐density lipoprotein cholesterol (LDL‐C) were reduced by 47% ± 8% (mean ± SD) in E3/2 subjects, 36% ± 10% in E3/3 subjects, and 26% ± 12% in E4/3 subjects after 12 weeks of treatment with pravastatin (all p < 0.0001). Plasma levels of apo B were decreased by 40% ± 12% in E3/2 subjects, 27% ± 10% in E3/3 subjects, and 18% ± 14% in E4/3 subjects after 12 weeks of treatment with pravastatin (all p < 0.0001). The reduction in plasma levels of LDL‐C and apo B was most marked in E3/2 subjects, next in E3/3 subjects, and smallest in E4/3 subjects. The authors conclude that treatment with pravastatin at a dose of 20 mg/day in Japanese subjects is equally effective as 40 mg/day in Western subjects, and apo E polymorphism is a factor to determine the efficacy of pravastatin in Japanese subjects.