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Effects of atorvastatin and vitamin C on endothelial function of hypercholesterolemic patients
F Perticone1, R Ceravolo, R Maio
1Cardiovascular Diseases Unit, Department of Medicina Sperimentale e Clinica 'G Salvatore', Policlinico Mater Domini, Via Tommaso Campanella, University of Catanzaro, 88100, Catanzaro, Italy. perticone@unicz.it
Insights
Atorvastatin treatment significantly improved blood vessel function in hypercholesterolemic patients by enhancing endothelium-dependent vasodilation. This suggests that statins can rapidly improve nitric oxide bioavailability and combat oxidative stress.
Area of Science:
- Cardiovascular Research
- Pharmacology
- Endothelial Function
Background:
- Hypercholesterolemia is associated with endothelial dysfunction, impairing blood vessel relaxation.
- Oxidative stress is implicated as a key mechanism in hypercholesterolemia-induced endothelial dysfunction.
Purpose of the Study:
- To investigate the effects of atorvastatin on endothelium-dependent and independent vasodilation in hypercholesterolemic patients.
- To compare the vascular responses between hypercholesterolemic individuals and healthy controls.
Main Methods:
- Forearm blood flow (FBF) was measured using strain-gauge plethysmography.
- Vascular responses to acetylcholine (endothelium-dependent), sodium nitroprusside (endothelium-independent), and L-NMMA were assessed before and after 1 month of atorvastatin treatment.
- Participants included 18 hypercholesterolemic patients and 12 healthy volunteers.
Main Results:
- Hypercholesterolemic patients exhibited significantly attenuated acetylcholine-stimulated vasodilation compared to controls at baseline.
- Atorvastatin treatment significantly improved acetylcholine-induced FBF in hypercholesterolemic patients.
- Lipid-lowering therapy with atorvastatin enhanced L-NMMA-mediated effects, indicating improved basal nitric oxide production.
Conclusions:
- Endothelial dysfunction in hypercholesterolemia is linked to oxidative stress.
- Atorvastatin treatment rapidly improves both basal and stimulated endothelium-dependent vasodilation.
- Vitamin C demonstrated a consistent effect on vasodilation, independent of atorvastatin treatment status.
Abstract:
We tested the effects of vitamin C and atorvastatin treatment on endothelium-dependent and endothelium-independent vasodilation in 18 hypercholesterolemic patients (ten men and eight women, aged 20-46 years) in comparison with 12 normal volunteers (seven men and five women, aged 20-45 years). The responses of the forearm blood flow (FBF) to acetylcholine (ACh) (7.5, 15 and 30 microg/min), sodium nitroprusside (SNP) (0.8, 1.6, 3.2 microg/min) and L-NMMA (2, 4, 8 micromol/min) were evaluated at baseline and after 1 month of atorvastatin (10 mg/day) treatment. Drugs were infused into the brachial artery and FBF was measured by strain-gauge plethysmography. At baseline, the response to ACh was significantly attenuated in hypercholesterolemics versus controls: at the highest dose (30 microg/min), FBF was 27.0+/-3.4 versus 11.5+/-1.9 ml.100 ml tissue(-1).min(-1) respectively (P<0.0001). No significant differences were found between groups during SNP infusion. The atorvastatin treatment significantly improved ACh-stimulated FBF: at highest dose the FBF increased to 14.9+/-1.5 ml.100 ml tissue(-1). min(-1) (P<0.0001). Similarly, the L-NMMA endothelial effects were significantly enhanced by lipid-lowering treatment, supporting the improvement of basal nitric oxide. Vitamin C increased ACh-vasodilation in the same way before and after atorvastatin treatment. In conclusion, the endothelial dysfunction in hypercholesterolemics is due to an oxidative stress and atorvastatin rapidly improves both basal and stimulated endothelium-dependent vasodilation.