High‐dose atorvastatin improves vascular endothelial function in patients with leukoaraiosis

Abstract

Objective Leukoaraiosis (LA), as an age‐related white matter degeneration, is mainly caused by chronic ischemia. Our study aims to explore the efficacy of different doses of atorvastatin (ATV) in the vascular endothelial function in patients with LA. Methods Our study enrolled 402 LA patients who were then randomly included as control or treated with ATV (10 mg), ATV (20 mg), or ATV (30 mg). The total cholesterol (TC), triglycerides (TG), high‐density lipoprotein cholesterol (HDL‐C), and low‐density lipoprotein cholesterol (LDL‐C) were detected by enzyme colorimetric assay. The high‐sensitivity C‐reactive protein (hs‐CRP) level, reactive hyperemia index (RHI), endothelin‐1 (ET‐1) content, and nitric oxide (NO) level were tested by latex agglutination test, peripheral arterial tonometry technology, radioimmunoassay, and nitrate reductase assay, respectively. Results After 8 weeks of ATV treatment, the levels of TC, LDL‐C, and HS‐CRP decreased significantly, and the trends were demonstrated in a more significant way with the increases of dose of ATV. The treatment with ATV at different doses elevated NO level and RHI and declined ET‐1 content. Gastrointestinal reaction, muscular pain, and increased aminopherase were observed after treatment with the ATV at different doses with more obvious symptoms detected accompanied by the increase of the dose. The RHI was in negative correlation with the ET‐1 and HS‐CRP while in positive correlation with NO. Conclusion Our study demonstrates that ATV can significantly improve the vascular endothelial function in LA patients with a dose‐dependent effect.

Correlation between the degree of leukoaraiosis and hyperlipidemia in post-ischemic stroke patients

“…17 Leukoaraiosis is expected in the elderly and is associated with recurrent stroke, cognitive decline, gait disturbances, hemorrhagic transformation, and functional abnormalities after ischemic stroke. 18,19 Most studies have investigated the correlation between active stroke and leukoaraiosis severity using computed tomography visual scales or volumetric measurements.…”

Leukoaraiosis: Epidemiology, Imaging, Risk Factors, and Management of Age-Related Cerebral White Matter Hyperintensities

“…352 The precise mechanism that mediates the effectiveness of statins therapy for retarding LA progression remains unclear to date. Statins may help to delay the progression of LA through pleiotropic mechanisms including improving endothelial function and cerebral vasoreactivity, [354][355][356] attenuating inflammatory response, 357,358 and decreasing oxidative stress. 358,359 Although more evidence described above seem to suggest statins as an efficient treatment against LA, the lipid-lowering treatment may have to be cautiously managed due to some conflicting findings that statin treatment was associated with increased risk of LA worsening.…”

“…The precise mechanism that mediates the effectiveness of statins therapy for retarding LA progression remains unclear to date. Statins may help to delay the progression of LA through pleiotropic mechanisms including improving endothelial function and cerebral vasoreactivity [ 354 - 356 ], attenuating inflammatory response [ 357 , 358 ], and decreasing oxidative stress [ 358 , 359 ].…”

Leukoaraiosis and acute ischemic stroke

“…Xue et al enrolled 402 LA patients who were then randomly included as control or treated with atorvastatin (ATV) (10 mg), ATV (20 mg) or ATV (30 mg). Their research showed that high-dose atorvastatin can improve vascular endothelial function in patients with LA (Xue et al, 2020). In addition to undertaking the abovementioned treatment, doctors should also actively treat the basic underlying diseases such as hypertension and diabetes.…”