title: Short-term atorvastatin treatment improves endothelial function in hypercholesterolemic women.
abstract: Endothelial dysfunction represents the earliest stage of atherosclerosis and is usually present in hypercholesterolemia. Treatment with statins has been shown to normalize endothelial function in middle-aged men with hypercholesterolemia. We evaluated the effect over time of atorvastatin on the endothelial reactivity in postmenopausal hypercholesterolemic women (mean age, 58 +/- 6 years), receiving atorvastatin, 10 mg daily (n = 20) or American Heart Association step 1 diet (n = 10) for 8 weeks. Lipid profile and brachial artery flow-mediated vasodilation (FMV) were determined at baseline and after 1, 2, 4, and 8 weeks. FMV increased progressively in subjects treated with atorvastatin, and the difference was significant (p < 0.05 vs. baseline) after the second week (baseline 3.8 +/- 3%; first week, 4.8 +/- 3%; second week, 9.2 +/- 3%; fourth week, 11.0 +/- 3%; eighth week, 11.7 +/- 3%). No significant changes were observed in subjects receiving diet (baseline, 3.1 +/- 4%; first week, 2.4 +/- 2%; second week, 2.9 +/- 2%; fourth week, 3.1 +/- 2%; eighth week, 3.3 +/- 2%; p = NS). In the atorvastatin group, low-density lipoprotein (LDL) cholesterol showed a significant decrease since the first week (baseline, 228 +/- 37 mg/dl; first week, 171 +/- 32; second week, 147 +/- 27; fourth week, 139 +/- 29; eighth week, 135 +/- 27; all p < 0.05). In the control group, LDL cholesterol showed a smaller but significant (p < 0.05) reduction after the second week (baseline, 226 +/- 17 mg/dl; first week, 225 +/- 16; second week, 220 +/- 17; fourth week, 203 +/- 27; eighth week, 198 +/- 27). In conclusion, hypercholesterolemic women treated with atorvastatin show a significant improvement in endothelial reactivity after as early as 2 weeks of therapy. The extent to which these beneficial effects are attributable to cholesterol reduction or to a direct effect of the drug remains to be established.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Perugia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Marchesi
authors.forename: G
authors.initials: G
authors.lastname: Lupattelli
authors.forename: D
authors.initials: D
authors.lastname: Siepi
authors.forename: G
authors.initials: G
authors.lastname: Schillaci
authors.forename: G
authors.initials: G
authors.lastname: Vaudo
authors.forename: A R
authors.initials: AR
authors.lastname: Roscini
authors.forename: H
authors.initials: H
authors.lastname: Sinzinger
authors.forename: E
authors.initials: E
authors.lastname: Mannarino
mesh_terms: D000704:Analysis of Variance; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D002784:Cholesterol / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy / Q000188:drug therapy*; D008074:Lipoproteins / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause; D011758:Pyrroles / Q000627:therapeutic use*; D014664:Vasodilation / Q000187:drug effects*
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D008074:Lipoproteins; D011758:Pyrroles; D002784:Cholesterol; D000069059:Atorvastatin