Clinical studiesEffects of lovastatin on cognitive function and psychological well-being∗☆,
Section snippets
Material and methods
Subjects were generally healthy men and women with hypercholesterolemia, defined as a serum low-density-lipoprotein (LDL) cholesterol level 160 mg/dL or higher, between the ages of 24 and 60 years. After stratification by sex and age (45 years and younger, older than 45 years), each participant was randomly assigned to daily treatment with lovastatin (Mevacor, Merck and Co., Rahway, New Jersey, 20 mg) or matching placebo for 6 months. Exclusion criteria included secondary hyperlipidemia
Results
Overall, subjects were young to middle aged, mostly employed with some college education and moderate hypercholesterolemia (Table 1). Five of the 192 participants who completed the study had a history of ischemic heart disease. Baseline measures from a sample of neuropsychological tests and quality-of-life scales are provided in Table 1; additional pretreatment data appear in Table 2, Table 3. Mean systolic blood pressure was somewhat greater in the subjects assigned to lovastatin, but it was
Discussion
We studied the effects of pharmacologic cholesterol lowering on a broad range of cognitive skills and indexes of psychological well-being among nonelderly subjects with moderate hypercholesterolemia. We found significant effects of lovastatin treatment on measures of psychomotor and attentional processes, as compared with placebo. Performance in three other domains—mental flexibility, working memory, and memory recall—also tended to decrease compared with placebo, but the differences were not
References (67)
- et al.
Low or lowered cholesterol and risk of death from suicide and trauma
Metabolism
(1993) Influence of polyunsaturated and saturated dietary lipids on adipose tissue, brain and mitochondrial membrane fatty acid composition of a mammalian hibernator
Biochimica et Biophysica Acta
(1990)- et al.
Effects of dietary fatty acid composition on macronutrient selection and synaptosomal fatty acid composition in rats
J Nutr
(1989) - et al.
Dietary polyunsaturated fatty acids and depressionwhen cholesterol does not satisfy
Am J Clin Nutr
(1995) - et al.
In vivo modulation of brain cholesterol level and learning performance by a novel plant lipidindications for interactions between hippocampal-cortical cholesterol and learning
Life Sci
(1986) - et al.
Can altering serum cholesterol affect neurologic functions?
J Mol Cell Cardiol
(1991) - et al.
Serum lipid concentrations in patients with major depressive disorder
Biol Psychiatry
(1996) - et al.
Low serum cholesterol in suicide attempters
Biol Psychiatry
(1997) - et al.
Enhanced oxidizability of ubiquinol and tocopherol during lovastatin treatment
FEBS Letters
(1997) - et al.
Effects of simvastatin on the metabolism of polyunsaturated fatty acids and on glycerolipid, cholesterol, and de novo lipid synthesis in THP-1 cells
J Lipid Res
(1997)
Effects of cholesterol lowering on mortalitya quantitative review of primary prevention trials
Br Med J
Injury, death, and cholesterol
Ann Intern Med
Randomised trial of cholesterol lowering in 4444 patients with coronary heart diseasethe Scandinavian Simvastatin Survival Study (4S)
Lancet
The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels
NEJM
Cholesterol, violent death, and mental disorder
Br Med J
Effects of dietary fat on pain threshold, thermoregulation and motor activity in rats
Pharmacol Biochem Behav
Influence of dietary lipids on agonistic and affiliative behavior in Macaca fascicularis
Am J Primatol
Cholesterol and violenceis there a connection?
Ann Intern Med
Report of the conference on low blood cholesterolmortality associations
Circulation
Serum cholesterol and aggression in hospitalized male forensic patients
J Behav Med
Plasma lipid levels and psychologic characteristics in men
Am J Epid
Assessing the observed relationship between low cholesterol and violence-related mortalityimplications for suicide risk
Ann New York Acad Sci
Do low cholesterol levels slow mental processing?
Psychosom Med
Serum cholesterol and intellectual performance
Psychosom Med
Decline in cognitive performance in aging twins. Heritability and biobehavioral predictors from the National Heart, Lung, and Blood Institute Twin Study
Arch Neurol
Factors associated with cognitive impairment among older Italian inpatients
J Am Geriat Soc
Association between features of the insulin resistance syndrome and Alzheimer’s disease independently of apolipoprotein E4 phenotypecross sectional population based study
BMJ
Estimation of the concentration of low density lipoprotein cholesterol in plasma without the use of the preparative ultracentrifuge
Clin Chem
Hypertension and neuropsychological performance in meninteractive effects of age
Health Psych
Central nervous system effects of HMG CoA reductase inhibitorslovastatin and pravastatin on sleep and cognitive performance in patients with hypercholesterolemia
Clin Pharm
Do cholesterol-lowering agents affect brain activity? A comparison of simvastatin, pravastatin, and placebo in healthy volunteers
Br J Clin Pharm
Effects of treatment with lovastatin and pravastatin on daytime cognitive performance
Clin Cardiol
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2022, Journal of Affective DisordersCitation Excerpt :Fifty-nine potentially eligible articles were assessed full-text, of which 14 were finally included in this systematic review. The characteristics of the 14 retrieved trials (Carlsson et al., 2002; Chan et al., 2017; Gengo et al., 1995; Harrison and Ashton, 1994; Hyyppä et al., 2003; Morales et al., 2006; Muldoon et al., 2000; Robertson et al., 2017; Santanello et al., 1997; Sheridan et al., 2014; Sparks et al., 2005; Stewart et al., 2000; Visseren et al., 2001; Wardle et al., 1996) were reported in Table 1. The study samples included: nine trials in people with hyperlipidaemia (Carlsson et al., 2002; Gengo et al., 1995; Hyyppä et al., 2003; Morales et al., 2006; Muldoon et al., 2000; Santanello et al., 1997) of which two involving patients with comorbid coronary artery disease (Stewart et al., 2000; Wardle et al., 1996) while one trial included comorbid type-2 diabetes mellitus (Visseren et al., 2001); one trial in healthy volunteers (Harrison and Ashton, 1994); one trial on patients with secondary progressive multiple sclerosis (Chan et al., 2017); one trial in adults with traumatic brain injury (Robertson et al., 2017); one trial in patients diagnosed with mild-to-moderate Alzheimer disease (Sparks et al., 2005); one trial in individuals affected by chronic hepatitis C (Sheridan et al., 2014).
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Supported by the Public Health Service (HL46328). The placebo and lovastatin tablets were donated by Merck and Co.
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