One-month therapy with simvastatin restores endothelial function in hypercholesterolemic children and adolescents.
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.
Ferreira
Waldinai Pereira
WP
Instituto Dante Pazzanese de Cardiologia, Av. Dr. Dante Pazzanese, 500 Bairro Ibirapuera, 04012-180 São Paulo, Brazil. wferreir@uol.com.br
Bertolami
Marcelo Chiara
MC
Santos
Simone Nascimento
SN
Barros
Marcos Roberto A C
MR
de Matos Barretto
Rodrigo Bellio
RB
Pontes
Sèrgio Cunha
SC
Fonseca
Francisco Hermann
FH
Carvalho
Antonio Carlos
AC
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
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D002784:Cholesterol; D019821:Simvastatin