Reduction in carotid arterial wall thickness using lovastatin and dietary therapy: a randomized controlled clinical trial.
OBJECTIVE
To assess the effects of lipid-lowering therapy on the progression of early, preintrusive carotid arterial atherosclerosis.


METHODS
Randomized, double-blind, placebo-controlled, serial carotid arterial imaging trial.


METHODS
University Atherosclerosis Research Unit.


METHODS
188 patients from the Monitored Atherosclerosis Regression Study who were 37 to 67 years of age and had angiographically defined coronary artery disease.


METHODS
Cholesterol-lowering diet plus placebo or lovastatin, 80 mg/d.


METHODS
High-resolution B-mode ultrasonographic quantification of the combined thickness of the distal common carotid arterial far wall intima-media complex (carotid arterial intima-media thickness) at baseline and every 6 months for as long as 4 years.


RESULTS
The annual rate of change in carotid arterial intima-media thickness differed significantly between the lovastatin group and the placebo group at 2 and 4 years (P < 0.001).


CONCLUSIONS
Lipid-lowering therapy reverses the progression of early, preintrusive atherosclerosis of the carotid artery. Both cholesterol-rich and triglyceride-rich lipoproteins correlate with the progression of early, preintrusive atherosclerosis of the carotid artery. These findings, together with earlier reports of the effects of lovastatin therapy on the progression of atherosclerosis of the coronary arteries, indicate that carotid arterial far wall intima-media thickness is a useful end point for anti-atherosclerosis trials.
Hodis
H N
HN
University of Southern California School of Medicine, Los Angeles, California, USA.
Mack
W J
WJ
LaBree
L
L
Selzer
R H
RH
Liu
C
C
Liu
C
C
Alaupovic
P
P
Kwong-Fu
H
H
Azen
S P
SP
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000188:drug therapy*; D002339:Carotid Arteries / Q000187:drug effects*; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008148:Lovastatin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D017539:Tunica Intima / Q000187:drug effects; D014463:Ultrasonography
D000924:Anticholesteremic Agents; D008055:Lipids; D010919:Placebos; D008148:Lovastatin