title: Short- and long-term influence of diet and simvastatin on brachial artery endothelial function.
abstract: BACKGROUND
  Endothelium-dependent dilation (EDD) has often been studied in patients with hypercholesterolemia without overt coronary atherosclerosis where an improvement after statin treatment has been documented within few weeks. The aim of the study was to assess the short-term effect of diet as well as short- and long-term effect of simvastatin on EDD in patients with hypercholesterolemia and ischemic heart disease.
  
  
  METHODS
  In 43 male patients with hypercholesterolemia and ischemic heart disease, EDD of the brachial artery was measured at baseline, after 3 months on a lipid-lowering diet, and after another 1, 3 and 12 months on simvastatin at 40 mg/day.
  
  
  RESULTS
  Three months changes in EDD were neither influenced by diet nor short-term simvastatin therapy (4.9% vs. 4.9% vs. 4.8%, p=ns). Twelve months simvastatin treatment, however, significantly improved EDD by 32.7% (4.9% vs. 6.5%, p=0.007). By regression analysis an individual adjusted increase in EDD during the simvastatin treatment period was seen (coefficient 0.132 a month, p=0.002). A significant reduction in total cholesterol of 31.0% (6.1+/-0.8 vs. 4.2+/-0.7, p<0.001) and LDL cholesterol of 42.6% (4.0+/-0.8 vs. 2.2+/-0.6, p<0.001) was observed.
  
  
  CONCLUSIONS
  EDD is improved after long-term simvastatin therapy; however, neither did 3 months diet or 3 months simvastatin therapy has influence on the EDD.
authors.affiliation: Department of Cardiology, Catheterization Laboratory, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense, Denmark. okkels@dadlnet.dk
authors.forename: Lisette Okkels
authors.initials: LO
authors.lastname: Jensen
authors.forename: Per
authors.initials: P
authors.lastname: Thayssen
authors.forename: Knud Erik
authors.initials: KE
authors.lastname: Pedersen
authors.forename: Torben
authors.initials: T
authors.lastname: Haghfelt
mesh_terms: D000368:Aged; D001916:Brachial Artery / Q000187:drug effects* / Q000502:physiology; D008078:Cholesterol, LDL / Q000187:drug effects; D018752:Diet, Fat-Restricted; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D006937:Hypercholesterolemia / Q000178:diet therapy* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000178:diet therapy* / Q000188:drug therapy*; D011446:Prospective Studies; D019821:Simvastatin / Q000494:pharmacology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin