Helsinki Heart Study

J2. Jauhiainen, M., Koskinen, P., Ehnholm, C., Heikki Frick, M., Manttari, M., Manninen, V., and Huttunen, J. K., Lipoprotein(a) and coronary heart disease risk A nested case-control study of the Helsinki heart study participants. Atherosclerosis (Shannon, Irel.) 89, 59-76 (1991). 

Similar results were found in the Helsinki Heart Study (HHS) of gemfibrozil (Manninen et al., 1988). Over one-third of patients were poorly or partially compliant, with placebo and active alike (Maenpaa et al., 1987 Manninen et al., 1988). The cholesterol fractions varied in relation to compliance with gemfibrozil, but not with placebo (Manninen et al., 1988). 

Huttunen, J.K., Manninen, V., and Manttary, M. 1991. The Helsinki heart study, central findings and clinical implications. Ann. Med. 53, 155-159. 

Frick, M.H. Elo, O. Haapa, K. Heinonen, O.P. Heinsalmi, P. Helo, P., et al. Helsinki heart study Primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N. Engl. J. Med. 1987, 317, 1237-1245. 

AECAPS/TexCAPS = Air ForceAexas Coronary Atherosclerosis Prevention Study (Downs et ah, 1998) Helsinki = The Helsinki Heart Study (Frick et al., 1 987) LRC-CPPT = The Lipid Research Clinics Coronary Primary Prevention Trial (insull et al., 1984) Oslo = The Oslo Study (Hjermann et ah, 1988) WOSCOPS = The West of Scotland Coronary Prevention Study (Shepherd et al., 1995) ALLHAT = Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial approximately 13-15% of patients had a history of coronary heart disease (CHD) events are CHD events only WHI = Women s Health initiative RRR = relative risk reduction ARR = absolute risk reduction NNT = number needed to treat NA = not available CEE = conjugated equine estrogen MPA = medroxyprogesterone acetate CARDS = Collaborative Atorvastatin Diabetes Study (presented at the 2004 American Diabetes Association meeting). 

Huttunen JK, Manninen V, Manttari M, et al. The Helsinki Heart Study Central findings and clinical implications. Ann Med 1991 23 155-159. 

IRS greatly increases CVD risk [24,25,70,71], and the results of the VA-HIT and Helsinki Heart studies [72-74], it would seem prudent to aggressively treat hypertriglyceridemia when present in patients with essential hypertension. 

Manninen V, Tenkanen L, Koskinen P, et al. Joint effects of serum triglyceride and DDL and HDD cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study implications for treatment. Circulation 1992 85 37 5. 

RCTs supporting the benefits of fibrate therapy is not consistent. Gemfibrozil was used in the Helsinki Heart Study, a primary prevention trial in men with raised non-HDL-cholesterol [55], and the Veterans Administration HDL Intervention Trial, VAHIT, a secondary CVD prevention trial in men with low HDL-cholesterol and relatively normal LDL [56], These studies showed significant positive benefit for the drug overall and in diabetic subgroups. However, the populations studied in these trials also respond well to statin therapy [43], In the Bezafibrate Infarction Prevention Trial, a CVD secondary prevention trial [57], there was a trend... 

Helsinki Heart Study (15) have all demonstrated the benefit of lipid lowering using various hypolipidemic agents for prevention of initial cardiac events. Secondary prevention trials have unequivocally shown that lipid lowering therapy not only reduces acute coronary events and other clinical endpoints, but also results in angiographic improvement. These studies have used different classes of drugs (statins, fibrates, niacin, bile acid resins—alone and in combination) in both hyper- and normo-cholesterolemic patients with established CAD. 

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