Cholesterol lowering with high-viscosity hydroxypropylmethylcellulose.

Hydroxypropylmethylcellulose (HPMC) is a food gum having several structural and functional properties in common with hypocholesterolemic soluble fibers. The safety and cholestero-lowering efficacy of HPMC, incorporated into a National Cholesterol Education Program Step I diet, was compared with placebo in patients with mild to moderate hypercholesterolemia. After an 8-week National Cholesterol Education Program Step I dietary lead-in phase, 160 patients with low-density lipoprotein (LDL) cholesterol between 130 and 200 mg/dl and triglycerides <300 mg/dl were randomized to placebo, 2.5, 5.0, or 7.5 g/day of HPMC for a 6-week treatment period. Patients returned to the clinic every 2 weeks for lipid measurements and safety assessments. HPMC significantly lowered total, LDL, and non-high-density lipoprotein (HDL) cholesterol. LDL cholesterol concentrations (average of weeks 4 and 6) decreased by 3.0% (4.9 mg/dl), 5.9% (10.3 mg/dl), 12.1% (20.4 mg/dl), and 11.7% (20.3 mg/dl) from baseline levels in the placebo and 2.5, 5.0, and 7.5 g/day HPMC treatment groups, respectively. Statistically significant (p<0.05) reductions in LDL cholesterol were observed in the 5.0 and 7.5 g/day HPMC groups compared with placebo and 2.5 g/day HPMC treatment groups. Total and non-HDL cholesterol responses paralleled those of LDL cholesterol. There were no significant differences between the treatment groups in HDL cholesterol or triglyceride responses, incidence of adverse experiences, or gastrointestinal-related adverse experiences. These results suggest that HPMC is a well-tolerated and effective adjunct to diet for lowering LDL cholesterol in patients with mild to moderate hypercholesterolemia.

Menopause and African-American women: clinical and research issues.

There are currently 3.7 million African-American women aged 35-54 years, and over the next 20 years virtually all of them will experience menopause. Although menopause itself is generally thought of as a naturally occurring biological phenomenon, undergoing the process can increase a woman's risk of disease. This phenomenon is common to women in all racial and ethnic groups. Across these groups, however, the process may be subject to great variability. This article does not include issues related to all minority women, but instead focuses on menopause in African-American women. It is important to note that there may be issues among Asian and Hispanic women that are very different from those of whites and blacks. Unfortunately, there is very little epidemiologic data on menopause or its antecedents in African-American women or in women of other minority groups. To stimulate epidemiologic research into the process of menopause among African-American women, this report will examine data from clinical and government sources. A common problem is that these sources overlook aspects of menopause important for the health of black women in mid and later life, such as menopause-associated symptoms, potentially beneficial hormonal therapies, and potentially debilitating skeletal disease.