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Simvastatina vs Cambios del Estilo de Vida y Suplementos: Prueba de Prevención Primaria al Azar

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En esta ocasión quisiera proponer un análisis de un artículo publicado en el Mayo Clinic Proceedings, en él se analizan los beneficios de los cambios en el estilo de vida, de los conocemos de sobra su importancia y programas como UNEME SORID les da un papel importante, contra el uso de la Simvastatina, los resultados favorecen al tratamiento “no” médico, pero creo que debemos ser muy analíticos a la hora de leer artículos como el que aquí propongo y que espero genere una rica discusión, ya que al menos en mi parecer los medicamentos tienen un papel importante en el tratamiento de las dislipidemias y aunque en este caso se trata de un Estudio de Prevención Primaria, dejan entrever si no se tiene cuidado al analizar la información, llevandonos a la idea equivocada de que se trata de una alternativa directa al uso de medicamentos en el tratamiento, ¿qué opinan?

Espero sus comentarios en el foro: http://www.medicinaintegrada.org.mx/foros/topic.php?id=24

Este artículo puede ser descargado en: http://www.mayoclinicproceedings.com/pdf/8307/8307a.pdf

Simvastatin vs Therapeutic Lifestyle Changes and Supplements:

Randomized Primary Prevention Trial

Mayo Clin Proc. 2008;83(7):758-764

Objetive: To compare the lipid-lowering effects of an alternative regimen (lifestyle changes, red yeast rice, and fish oil) with a standard dose of a 3-hydroxy-3-methylglutaryl coenzyme A reductase
inhibitor (statin).

Patients and Methods: This randomized trial enrolled 74 patients with hypercholesterolemia who met Adult Treatment Panel III criteria for primary prevention using statin therapy. All participants
were randomized to an alternative treatment group (AG) or to receive simvastatin (40 mg/d) in this open-label trial conducted between April 1, 2006, and June 30, 2006. The alternative
treatment included therapeutic lifestyle changes, ingestion of red yeast rice, and fish oil supplements for 12 weeks. The simvastatin  group received medication and traditional counseling. The primary
outcome measure was the percentage change in low-density lipoprotein cholesterol (LDL-C). Secondary measures were changes in other lipoproteins and weight loss.

Results: There was a statistically significant reduction in LDL-C levels in both the AG (–42.4%±15%) (P<.001) and the simvastatin group (–39.6%±20%) (P<.001). No significant differences were
noted between groups. The AG also demonstrated significant reductions in triglycerides (–29% vs –9.3%; 95% confidence interval, –61 to –11.7; P=.003) and weight (–5.5% vs –0.4%; 95%
confidence interval, –5.5 to –3.4; P<.001) compared with the simvastatin group.

Conclusion: Lifestyle changes combined with ingestion of red yeast rice and fish oil reduced LDL-C in proportions similar to standard therapy with simvastatin. Pending confirmation in larger
trials, this multifactorial, alternative approach to lipid lowering has promise for a subset of patients unwilling or unable to take statins.

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