Atorvastatin reduces arterial stiffness in patients with rheumatoid arthritis.
BACKGROUND
Chronic systemic inflammation may contribute to accelerated atherosclerosis and increased arterial stiffness in patients with rheumatoid arthritis (RA). In addition to lowering cholesterol, statins have immunomodulatory effects which may be especially beneficial in patients with RA who have systemic immune activation.


OBJECTIVE
To investigate the effect of atorvastatin on the augmentation index (AIx: a measure of arterial stiffness) and systemic inflammation in RA.


METHODS
29 patients with RA (mean (SD) age 55 (13) years) with moderately active disease of long duration were studied. AIx, lipid levels, serum inflammatory markers, and disease activity score were measured before and after 12 weeks of atorvastatin 20 mg daily.


RESULTS
AIx improved significantly from 34.1 (11.6)% to 29.9 (11)% (p = 0.0002), with the greatest improvements in AIx occurring in those subjects with the highest disease activity scores (r = -0.5, p = 0.007). Total and LDL cholesterol were reduced from 5.5 (0.9) to 3.9 (0.7) mmol/l and 3.3 (0.8) to 1.9 (0.6) mmol/l, respectively (p = 0.0001). Serum inflammatory markers remained unchanged during the study.


CONCLUSIONS
Atorvastatin significantly reduced arterial stiffness in patients with RA. The greatest improvements were seen in patients with more active disease, suggesting that, in addition to the beneficial effects of cholesterol reduction, immune modulation may contribute to the cardioprotective effect of statins.
Van Doornum
S
S
Department of Rheumatology, The Royal Melbourne Hospital, Parkville VIC 3050 Australia. sharon.vandoornum@mh.org.au.
McColl
G
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Wicks
I P
IP
D000328:Adult; D000368:Aged; D001158:Arteries / Q000187:drug effects* / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D000069059:Atorvastatin; D004341:Drug Evaluation; D004548:Elasticity / Q000187:drug effects; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow / Q000187:drug effects; D011758:Pyrroles / Q000494:pharmacology* / Q000627:therapeutic use; D017534:Radial Artery / Q000187:drug effects / Q000503:physiopathology
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D008055:Lipids; D011758:Pyrroles; D000069059:Atorvastatin