The efficacy of intensive dietary therapy alone or combined with lovastatin in outpatients with hypercholesterolemia

Donald B. Hunninghake, Evan A. Stein, Carlos A. Dujovne, William Harris, Elaine B. Feldman, Valery T. Miller, Jonathan A. Tobert, Peter M. Laskarzewski, Elaine Quiter, Jolene Held, Alice M. Taylor, Suzanne Hopper, Sandra B. Leonard, Brenda K. Brewer

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226 Scopus citations


Background. A diet low in saturated fat and cholesterol is the standard initial treatment for hypercholesterolemia. However, little quantitative information is available about the efficacy of dietary therapy in clinical practice or about the combined effects of diet and drug therapy. Methods. One hundred eleven outpatients with moderate hypercholesterolemia were treated at five lipid clinics with the National Cholesterol Education Program Step 2 diet (which is low in fat and cholesterol) and lovastatin (20 mg once daily), both alone and together. A diet high in fat and cholesterol and a placebo identical in appearance to the lovastatin were used as the respective controls. Each of the 97 patients completing the study (58 men and 39 women) underwent four consecutive nine-week periods of treatment according to a randomized, balanced design: a high-fat diet-placebo period, a low-fat diet-placebo period, a high-fat diet-lovastatin period, and a low-fat diet-lovastatin period. Results. The level of low-density lipoprotein (LDL) cholesterol was a mean of 5 percent (95 percent confidence interval, 3 to 7 percent) lower during the low-fat diet than during the high-fat diet (P

Original languageEnglish (US)
Pages (from-to)1213-1219
Number of pages7
JournalNew England Journal of Medicine
Issue number17
Publication statusPublished - Apr 29 1993
Externally publishedYes


ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hunninghake, D. B., Stein, E. A., Dujovne, C. A., Harris, W., Feldman, E. B., Miller, V. T., ... Brewer, B. K. (1993). The efficacy of intensive dietary therapy alone or combined with lovastatin in outpatients with hypercholesterolemia. New England Journal of Medicine, 328(17), 1213-1219.