Effects of simvastatin on walking performance and symptoms of intermittent claudication in hypercholesterolemic patients with peripheral vascular disease.
OBJECTIVE
To analyze the effects of short-term therapy with simvastatin on walking performance in hypercholesterolemic patients with peripheral vascular disease.


METHODS
Eighty-six patients with peripheral arterial disease (Fontaine stage II), intermittent claudication, and total cholesterol levels >220 mg/dL were enrolled in a randomized, placebo-controlled, double-blind study. Forty-three patients were assigned to simvastatin (40 mg/d); the remaining 43 patients were assigned to placebo treatment. All patients underwent an exercise test and clinical examination, and completed a self-assessment questionnaire at 0, 3, and 6 months. Pain-free and total walking distance, resting and postexercise ankle-brachial indexes, and questionnaire scores were determined at each follow-up.


RESULTS
At 6 months, the mean pain-free walking distance had increased 90 meters (95% confidence interval [CI]: 64 to 116 meters; P <0.005) more in the simvastatin group than in the placebo group. Similar results were seen for the total walking distance (mean between-group difference in the change, 126 meters; 95% CI: 101 to 151 meters; P <0.001), and for the ankle-brachial index at rest (mean, 0.09; 95% CI: 0.06 to 0.12; P <0.01) and after exercise (mean, 0.19; 95% CI: 0.14 to 0.24; P <0.005). There was also a greater improvement in claudication symptoms among patients treated with simvastatin. The effects on walking performance, ankle-brachial indexes, and questionnaire scores had also been significant at 3 months.


CONCLUSIONS
High-dose short-term therapy with simvastatin may improve walking performance, ankle-brachial pressure indexes, and symptoms of claudication in hypercholesterolemic patients with peripheral vascular disease.
Mondillo
Sergio
S
Cattedra di Malattie Cardiovascolari, Università degli Studi di Siena, Siena, Italy.
Ballo
Piercarlo
P
Barbati
Riccardo
R
Guerrini
Francesco
F
Ammaturo
Tiziana
T
Agricola
Eustachio
E
Pastore
Monica
M
Borrello
Francesco
F
Belcastro
Mirko
M
Picchi
Andrea
A
Nami
Renato
R
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001795:Blood Pressure Determination / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy*; D007383:Intermittent Claudication / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications*; D019821:Simvastatin / Q000627:therapeutic use*; D016138:Walking / Q000502:physiology*
D000924:Anticholesteremic Agents; D019821:Simvastatin