Effects of bezafibrate on low HDL-cholesterol in patients with ischaemic cerebrovascular disease: a pilot study.

Bezafibrate is a new lipid-lowering agent that quite constantly increases low HDL-cholesterol values in hyperlipoproteinaemic patients. The possible role fo HDL-cholesterol as an anti-atherogenic factor has been frequently discussed, mainly in patients with ischaemic heart disease but recently also in ischaemic cerebrovascular disease (ICD). This is the first pilot study in six selected patients suffering from ICD who had at the same time low HDL-cholesterol values (less than or equal to = 1.1 mmol/l) with otherwise normal lipids. After a wash-out period of 2 months duration these patients were treated with 200 mg bezafibrate t.i.d. for 2 months. They were then followed up for another 8 months. Bezafibrate therapy increased HDL-cholesterol (range 45-130%). Eight months after cessation of therapy five patients have returned to pathologically low HDL-levels and the sixth patient also has a relatively low value of 1.2 mmol/l. This small preliminary study cannot, however, provide evidence about the possible beneficial role of increasing HDL-cholesterol in patients with ICD. Further investigations are therefore in progress.