Long-term treatment with metformin in a large cohort of hyperlipidemic patients

Metformin (N,N-dimethyl biguanide) was given to a large cohort of hyperlipidemic patients (daily dose of 2,550 g) in an effort to control hyperlipidemia and to analyse possible cardiovascular changes. 254 patients completed a 6 month follow up; of these (134 males and 120 females), 92 were diagnosed as type IIA, 87 IIB and 81 type IV. A significant plasma triglyceride reduction was recorded in all three subgroups; the decrease was progressive throughout the duration of therapy and averaged 57.5%. Body weight was not markedly decreased (mean -2.3 kg), whereas glucose and uric acid levels were significantly reduced by treatment. Plasma cholesterol had an overall decrease of 4.3%, similar in all three subgroups. Some improvements were noted in hemodynamic parameters. In particular, a 13.2% decrease of diastolic blood pressure was recorded (95 to 82.4 mm Hg); the number of pathological EKG's (Minnesota code 2) was reduced and approximately 2/3 of the patients with oscillographic or plethysmographic signs of peripheral vascular disease had improved walking capacity, confirmed by the instrumental findings. This study shows the applicability of a hypolipidemic drug regimen in a relatively large patient sample from a medium sized town. The preliminary results also suggest that this regimen may favourably affect vascular function tests in treated patients.