Effects of atorvastatin on aortic pulse wave velocity in patients with hypertension and hypercholesterolaemia: a preliminary study

Abstract

As statins may contribute to plaque stabilisation, it is important to evaluate whether these drugs may modify arterial stiffness. In 23 patients, aged 32-70 years, with hypertension and hypercholesterolaemia, a doubleblind randomised study vs placebo was performed to evaluate whether atorvastatin was able to modify aortic stiffness, measured from aortic pulse wave velocity (PWV), after a 12-week treatment. The results revealed that atorvastatin did not change blood pressure, significantly lowered (Po0.003; o0.002) plasma total and LDL cholesterol, and increased aortic PWV by +8% (vs À2% under placebo) (P40.05). The percentage changes in plasma total and LDL cholesterol and in PWV were significantly and negatively correlated, independent of blood pressure level. The finding of increased aortic PWV after 12-week statin treatment agrees with studies in monkeys, indicating that, at the early phase of hypolipidaemic diet but not later, aortic PWV increases transiently as a consequence of the significant reduction of lipid vascular content. In conclusion, the present results support the possibility that statins might contribute to a change in arterial stiffness independent of blood pressure level, and suggest that long-term studies in humans are needed to evaluate the contribution of arterial elasticity to statin-induced vascular remodelling.

Long-term effects of statins on arterial pressure and stiffness of hypertensives

“…15 Radical reductions in lipid levels may lead to a transient stiffening of arterial walls, because vessels are composed of both soft (lipid-containing) and rigid (sclerotic) tissue. In addition, the ability of fluvastatin and simvastatin to inhibit proliferation and cholesterol biosynthesis in human arterial myocytes is approximately 10-25 times greater than that of atorvastatin.…”

“…However, a recent study reported that 12-week atorvastatin treatment worsened PWV in hypertensive hyperlipidaemic patients. 15 The purpose of the present study was to determine the long-term effects of statins on BP control and PWV in hypertensive hyperlipidaemic patients undergoing antihypertensive therapy. Since recent in vivo studies in rabbits 16 and in vitro data [17][18][19] have indicated that hydrophilic and lipophilic statins have different effects on apoptosis, proliferation of vascular smooth muscle cells, and collagen production by vascular smooth muscle cells, in the present study we evaluated the effects of a hydrophilic drug, pravastatin, and two lipophilic drugs, simvastatin and fluvastatin, on the PWV of hypertensive patients with high serum cholesterol levels.…”

Errors in Estimating Propagation Distances in Pulse Wave Velocity

“…4 In fact, a literature search revealed that other investigators using this instrument have also measured unreasonably high aortic PWVs. [5][6][7] It appears the problem lies with the error in estimation of the propagation distance of the traveling pulse. The manufacturer recommends the use of the absolute distance between the 2 transducers as the propagation distance.…”

Arterial stiffening in hypertension: beyond blood pressure levels

“…Accordingly, treatment with statins, medicines with recognized pleiotropic anti-inflammatory properties has been shown to reduce pulse wave velocity. 7 In this issue of the Journal of Human Hypertension, Marketou et al 8 report extremely strong correlations between the expression of angiopoietins' mRNA by CD14 þ monocytes and the elastic behaviour of both elastic type and muscular type arteries. In fact, such amazingly strong correlations (r up to 0.95) are extremely rare in biological sciences and must indicate direct link between the factors analysed.…”