OBJECTIVE: To determine the effect of atorvastatin on postprandial lipaemia in overweight or obese women with the apoprotein (apo) E3/E3 genotype. DESIGN: Double-blind randomised, placebo-controlled 8-week single-centre study. SUBJECTS: Twenty-two healthy women, homozygous for apo E3 with a BMI ranging from 27.6 to 41.1 kg/m2 and normal or moderately elevated fasting triglycerides (53-184 mg/dl). TREATMENT: After a 4-week isocaloric single-blind, placebo lead-in period, subjects were randomly assigned to receive either placebo (n = 7) or atorvastatin 20 mg once daily in the evening (n = 15) for 4 weeks. RESULTS: Atorvastatin significantly reduces fasting total cholesterol, LDL-cholesterol and postprandial triglycerides in obese women, homozygous for apo E3 with normal or near-normal fasting triglyceride levels. No significant effect on fasting triglycerides was observed. CONCLUSION: Atorvastatin decreases postprandial hyperlipidaemia, an independent cardiovascular risk factor, in normolipidaemic obese women.This effect of atorvastatin may, therefore, represent a cardioprotective mechanism.