Taking simvastatin in the morning compared with in the evening: randomised controlled trial
Taking simvastatin in the morning compared with in the evening: randomised controlled trial
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DOI：
10.1136/bmj.327.7418.788
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发表时间：
2003-10-04
影响因子：
--
通讯作者：
Rubin, G
中科院分区：
文献类型：
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作者：
Wallace, A;Chinn, D;Rubin, G
他汀类药物广泛用于冠状动脉疾病的一级和二级预防。它们通过抑制 HMG CoA 还原酶发挥作用，该酶控制肝脏中胆固醇的合成。大多数他汀类药物制造商建议在晚上服用，生理学研究表明，大多数胆固醇是在饮食摄入量最低时合成的。 1 一项小型临床试验发现，早上服用比治疗剂量小的辛伐他汀效果较差。 2 然而，一项使用阿托伐他汀的试验发现，早上服用他汀类药物的患者与晚上服用他汀类药物的患者之间的胆固醇浓度没有显着差异。 3 人们对他汀类药物是否需要在夜间服用存在疑问，4 特别是因为许多患者还接受其他心脏保护药物的治疗，并且多次给药可能会影响依从性。 5 通过测量禁食患者血清中的胆固醇浓度，我们确定早上服用辛伐他汀与晚上服用辛伐他汀的疗效是否存在显着差异。
Statins are widely prescribed for the primary and secondary prevention of coronary artery disease. They act by inhibiting the enzyme HMG CoA reductase, which controls synthesis of cholesterol in the liver. Most manufacturers of statins recommend that they are taken at night, on the basis of physiological studies which show that most cholesterol is synthesised when dietary intake is at its lowest. 1 One small clinical trial found that taking smaller doses of simvastatin than are used in treatment, in the morning, was less efficient. 2 However, a trial using atorvastatin found no significant difference in cholesterol concentrations between patients taking the statin in the morning and those taking it in the evening. 3Doubt has been cast on whether statins need to be taken at night, 4 particularly as many patients also receive treatment with other cardioprotective drugs and compliance may be compromised by multiple dosing. 5 We determined whether taking simvastatin in the morning had significantly different efficiency from taking it in the evening, by measuring cholesterol concentrations in fasting patients’ serum.