title: One-month therapy with simvastatin restores endothelial function in hypercholesterolemic children and adolescents.
abstract: Simvastatin has been shown to restore endothelial function in children with familial hypercolesterolemia after 28 weeks of treatment. The aim of this study was to evaluate 1-month simvastatin treatment effect on endothelial function in hypercholesterolemic children and adolescents. Eighteen hypercholesterolemic patients (HC group) and 18 healthy controls, aged 6-18 years, were studied with medical history, physical examination, full lipid profile, serum apolipoprotein B (apo B), fibrinogen, hepatic transaminases, and creatine kinase concentrations. Flow-mediated dilatation (FMD) was performed by high-resolution ultrasound of the brachial artery. The HC group received simvastatin 10 mg/day for 1 month. Arterial diameter was measured by two experienced sonographers who were unaware of subjects' conditions. At baseline, FMD was impaired in the HC group (mean, 5.27 +/- 4.67%) compared to controls (mean, 15.05 +/- 5.97%) (p < 0.001). After treatment, we observed a significant reduction in total cholesterol (TC) (29%), low-density lipoprotein cholesterol (LDL-C); (37%), apo B concentrations (36%) and FMD restoration (mean, 12.94 +/- 7.66%), with an absolute increase of 7.66 +/- 8.58 (p = 0.001). These results show that children and adolescents with hypercholesterolemia present endothelial dysfunction, and simvastatin, in addition to significantly reducing TC, LDL-C, and apo B concentrations, restores endothelial function with 1-month treatment.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, Av. Dr. Dante Pazzanese, 500 Bairro Ibirapuera, 04012-180 São Paulo, Brazil. wferreir@uol.com.br
authors.forename: Waldinai Pereira
authors.initials: WP
authors.lastname: Ferreira
authors.forename: Marcelo Chiara
authors.initials: MC
authors.lastname: Bertolami
authors.forename: Simone Nascimento
authors.initials: SN
authors.lastname: Santos
authors.forename: Marcos Roberto A C
authors.initials: MR
authors.lastname: Barros
authors.forename: Rodrigo Bellio
authors.initials: RB
authors.lastname: de Matos Barretto
authors.forename: Sèrgio Cunha
authors.initials: SC
authors.lastname: Pontes
authors.forename: Francisco Hermann
authors.initials: FH
authors.lastname: Fonseca
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Carvalho
mesh_terms: D000293:Adolescent; D001916:Brachial Artery / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002648:Child; D002784:Cholesterol; D004727:Endothelium / Q000187:drug effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D006937:Hypercholesterolemia / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D019821:Simvastatin / Q000627:therapeutic use*; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D002784:Cholesterol; D019821:Simvastatin