Long-term treatment effect of atorvastatin on aortic stiffness in hypercholesterolaemic patients.
OBJECTIVE
To assess the effect of atorvastatin on aortic stiffness in hypercholesterolaemic patients free of arterial hypertension and diabetes mellitus.


RESULTS
The study included 36 patients (25 men and 11 women, mean age 56 +/- 12 years); 18 patients had stable coronary heart disease (CHD) and 18 were free of CHD at baseline. All patients received atorvastatin (20 mg/day) for a 2-year period. Aortic stiffness was assessed by transthoracic echocardiography at baseline and 2 years later. At baseline, total cholesterol, low density lipoprotein cholesterol (LDL-C) and LDL-C/high density lipoprotein cholesterol (HDL-C) ratio were positively related to aortic stiffness (p < 0.001 for all). The mean change in lipid parameters during treatment was: total cholesterol -38%, LDL-C -46%, triglycerides -29%, and HDL-C +6%, all significant (p = 0.029 to < 0.0001). After the 2-year treatment with atorvastatin, aortic stiffness was significantly reduced by 14% (p = 0.019). An improvement of left ventricular (LV) ejection fraction by 13% (p < 0.001) and a reduction of LV mass index by 9% (p = 0.008) were also recorded. The change in aortic stiffness was similar in patients with or without CHD.


CONCLUSIONS
Long-term treatment with atorvastatin improves aortic stiffness; this index is related to total and coronary mortality. Moreover, assessment of aortic stiffness may be useful in identifying which hypercholesterolaemic patients should be treated aggressively, regardless of CHD. The aortic stiffness effect may eventually become an index of the efficacy of lipid lowering treatment.
Kontopoulos
Athanasios G
AG
Atherosclerosis Unit, Aristotelian University and Hippocration Hospital, Thessaloniki, Greece.
Athyros
Vasilios G
VG
Pehlivanidis
Anthimos N
AN
Demitriadis
Dimokritos S
DS
Papageorgiou
Athanasios A
AA
Boudoulas
Harisios
H
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001021:Aortic Valve / Q000503:physiopathology*; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D013995:Time; D014481:United States
D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D010919:Placebos; D011758:Pyrroles; D000069059:Atorvastatin