4-Year progression of early arterial wall lesions in asymptomatic hyperlipidemic subjects treated with bezafibrate

Abstract

Noninvasive, high-resolution, arterial ultrasonic biopsy (UB) was used to evaluate and follow up early arterial wall changes in 356 hyperlipidemic subjects (HLS) in a prospective 4-year follow-up study. UB findings at baseline were classified by severity of vascular damage and ranked to classes I through IV. HLSs were divided at random into a treatment group (low-fat diet and bezafibrate s.v. 400 mg/day) and a control group (low-fat diet). The rate of progression (ROP=percent of subjects progressing to the more advanced UB class) was monitored by UB, repeated every year. In the nontreated HLS, the ROP was higher (p<0.05) than in the treated group as 21.8% progressed whereas only 9.6% of the bezafibratetreated subjects progressed. In classes III and IV, the ROP was 9.5 and 18.6, respectively, in treated and significantly higher (17.4 and 53.7) (p<0.05) in untreated subjects. Bezafibrate was well tolerated. In conclusion, treatment of HLS with bezafibrate is effective in decreasing the ROP over a period of 4 years.