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[Effect of atorvastatin on endothelial function in patients with familial hypercholesterolemia]
Insights
Atorvastatin treatment significantly improved endothelial function in familial hypercholesterolemia patients by increasing flow-mediated dilation and reducing nitric oxide precursors. This study highlights atorvastatin
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biochemistry
Background:
- Familial hypercholesterolemia (FH) type IIa is a genetic disorder characterized by high cholesterol levels.
- Endothelial dysfunction is a key factor in the development of atherosclerosis.
- Statins, like atorvastatin, are widely used to lower cholesterol but their effects on endothelial function in FH require further investigation.
Purpose of the Study:
- To evaluate the impact of atorvastatin on endothelial function in patients with familial hypercholesterolemia type IIa.
- To assess changes in flow-mediated dilation (FMD) and nitric oxide (NO) production markers.
Main Methods:
- Sixteen FH patients received atorvastatin (20 mg/day) for 3 months.
- Flow-mediated endothelium-dependent vasodilatation (FMD) of the brachial artery was measured before and after treatment.
- Plasma nitrite/nitrate (NOx) levels were quantified as an indirect measure of NO production.
Main Results:
- Atorvastatin significantly reduced total cholesterol (32%), LDL cholesterol (41%), and triglycerides (16%), while increasing HDL cholesterol (21%).
- Flow-mediated dilation (FMD) improved significantly from 5.8% at baseline to 9.5% after treatment (p<0.002).
- Plasma NOx levels decreased significantly from 53.4 mcmol/l to 35.5 mcmol/l (p<0.02).
Conclusions:
- Atorvastatin treatment confers beneficial effects on endothelial function in patients with familial hypercholesterolemia.
- The improvements include enhanced flow-mediated dilation and reduced plasma NOx levels.
- These findings suggest atorvastatin may mitigate cardiovascular risk in FH patients by improving endothelial health.
Aim:
To study the influence of treatment with HMG-CoA reductase inhibitor atorvastatin on endothelial function in patients with familial hypercholesterolemia type IIa.
Materials And Methods:
Sixteen patients (5m/11w, 51-/+3 years) with familial hypercholesterolemia were studied before and after 3 months of therapy with atorvastatin 20 mg/day. EDRF release test (D.Celermajer, 1992) was used to assess flow-mediated endothelium-dependent vasodilatation (FMD) of the brachial artery in response to reactive hyperemia. Plasma nitrite/nitrate (NOx) levels were measured as an indirect index of nitric oxide (NO) production in vivo using HPLC.
Results:
Atorvastatin treatment resulted in a 32% reduction in total serum cholesterol (CH), 41% reduction in low density lipoprotein (LDL) CH, 16% reduction in triglycerides and a 21% increase in high density lipoprotein CH. Flow mediated dilatation (FMD) was impaired at baseline (5.8-/+0.9%) and significantly improved up to 9.5-/+0.9% after 3 month atorvastatin therapy (p<0.002). Change in FMD inversely correlated with baseline FMD (r = -0.58, p<0.05). There was no significant correlation between FMD and neither total serum CH nor LDL CH levels at baseline. During atorvastatin therapy significant reduction of plasma NOx levels occurred from 53.4-/+5.1 mcmol/l at baseline (range 42.6-86.2 mcmol/l) to 35.5-/+5.1 mcmol/l (18.4-46.0 mcmol/l) after treatment (p<0.02, n=7).
Conclusion:
In patients with familial hypercholesterolemia atorvastatin produced beneficial effect on endothelial function (increase in flow-mediated dilatation, decrease in NOx).