OBJECTIVES: To investigate the independent and combined effects of lifestyle changes and statin treatment on soluble markers of atherosclerotic activity. DESIGN: The study was a randomised, 2 x 2 factorial 1 year intervention trial. Participants (n=177) were sedentary, drug-treated, hypertensive men (aged 40-74 years). They were randomised to placebo, lifestyle intervention (diet and physical activity), fluvastatin 40 mg, or the combination of lifestyle and fluvastatin. RESULTS: Lifestyle intervention significantly reduced intercellular adhesion molecule-1 (sICAM-1) compared to usual care (p=0.003). Thrombomodulin level remained higher among individuals receiving lifestyle intervention (p=0.025). sICAM-1 was less reduced among fluvastatin treated participants compared to the placebo treated (p=0.029). Changes of blood pressure, weight or waist circumference were not significantly different between treatment groups. Individuals who achieved improvement of classical risk factors also had a significant reduction of endothelial markers (E-selectin, von Willebrands factor, tissue plasminogen activator antigen). CONCLUSIONS: One year of lifestyle intervention reduced the level of sICAM-1 in sedentary, drug-treated hypertensives, in spite of no impact on traditional risk factors. Low dose fluvastatin had no beneficial effect on the measured markers.
RCT Entities:
OBJECTIVES: To investigate the independent and combined effects of lifestyle changes and statin treatment on soluble markers of atherosclerotic activity. DESIGN: The study was a randomised, 2 x 2 factorial 1 year intervention trial. Participants (n=177) were sedentary, drug-treated, hypertensivemen (aged 40-74 years). They were randomised to placebo, lifestyle intervention (diet and physical activity), fluvastatin 40 mg, or the combination of lifestyle and fluvastatin. RESULTS: Lifestyle intervention significantly reduced intercellular adhesion molecule-1 (sICAM-1) compared to usual care (p=0.003). Thrombomodulin level remained higher among individuals receiving lifestyle intervention (p=0.025). sICAM-1 was less reduced among fluvastatin treated participants compared to the placebo treated (p=0.029). Changes of blood pressure, weight or waist circumference were not significantly different between treatment groups. Individuals who achieved improvement of classical risk factors also had a significant reduction of endothelial markers (E-selectin, von Willebrands factor, tissue plasminogen activator antigen). CONCLUSIONS: One year of lifestyle intervention reduced the level of sICAM-1 in sedentary, drug-treated hypertensives, in spite of no impact on traditional risk factors. Low dose fluvastatin had no beneficial effect on the measured markers.
Authors: Fiona Taylor; Mark D Huffman; Ana Filipa Macedo; Theresa H M Moore; Margaret Burke; George Davey Smith; Kirsten Ward; Shah Ebrahim Journal: Cochrane Database Syst Rev Date: 2013-01-31