H Shige1, A Dart, P Nestel. 1. Baker Medical Research Institute, POB 6492 St. Kilda Road, Vic. 8008, Melbourne, Australia.
Abstract
UNLABELLED: Several cardiovascular risk factors adversely affect arterial compliance or the distensibility of large arteries. The role of raised low-density lipoproteins (LDL) cholesterol is uncertain, most studies having shown little effect. We, therefore, investigated whether lowering LDL would improve arterial compliance. Twenty hypercholesterolemic subjects (LDL cholesterol 4.95+/-1.11 mmol/l) were randomized to simvastatin (20 or 40 mg daily) or placebo, each for 4 weeks. Arterial function was assessed at the end of the placebo and simvastatin periods, systemic arterial compliance (SAC) and pulse wave velocities (PWV) centrally (aorto-femoral) and peripherally (femoral-posterior tibial). RESULTS:Lipoproteins (LDL) cholesterol was reduced similarly with 20 and 40 mg simvastatin (ten subjects each dose) and data were pooled. Lipoproteins (LDL) cholesterol fell 39%, plasma triglyceride fell 18% and high-density lipoprotein (HDL) cholesterol rose 12%, all significant. Systemic arterial compliance (SAC) and central PWV did not change significantly but peripheral PWV showed evidence of greater compliance after simvastatin (10.1+/-1.3 vs. 9.4+/-1.3 m/s with placebo and simvastatin, P<0.03), distensibility being inversely related to PWV. Improvement in PWV was greatest in those with poorest baseline values, r=0.50; P<0.02. CONCLUSION: Peripheral PWV was alone improved with LDL lowering probably because of the muscularity of that arterial bed; central PWV and SAC (in the elastic aorta) were not influenced.
RCT Entities:
UNLABELLED: Several cardiovascular risk factors adversely affect arterial compliance or the distensibility of large arteries. The role of raised low-density lipoproteins (LDL) cholesterol is uncertain, most studies having shown little effect. We, therefore, investigated whether lowering LDL would improve arterial compliance. Twenty hypercholesterolemic subjects (LDL cholesterol 4.95+/-1.11 mmol/l) were randomized to simvastatin (20 or 40 mg daily) or placebo, each for 4 weeks. Arterial function was assessed at the end of the placebo and simvastatin periods, systemic arterial compliance (SAC) and pulse wave velocities (PWV) centrally (aorto-femoral) and peripherally (femoral-posterior tibial). RESULTS: Lipoproteins (LDL) cholesterol was reduced similarly with 20 and 40 mg simvastatin (ten subjects each dose) and data were pooled. Lipoproteins (LDL) cholesterol fell 39%, plasma triglyceride fell 18% and high-density lipoprotein (HDL) cholesterol rose 12%, all significant. Systemic arterial compliance (SAC) and central PWV did not change significantly but peripheral PWV showed evidence of greater compliance after simvastatin (10.1+/-1.3 vs. 9.4+/-1.3 m/s with placebo and simvastatin, P<0.03), distensibility being inversely related to PWV. Improvement in PWV was greatest in those with poorest baseline values, r=0.50; P<0.02. CONCLUSION: Peripheral PWV was alone improved with LDL lowering probably because of the muscularity of that arterial bed; central PWV and SAC (in the elastic aorta) were not influenced.
Authors: Adam G Goodwill; Stephanie J Frisbee; Phoebe A Stapleton; Milinda E James; Jefferson C Frisbee Journal: Microcirculation Date: 2009-11 Impact factor: 2.628