Effect of lifestyle and/or statin treatment on soluble markers of atherosclerosis in hypertensives.
OBJECTIVE
To investigate the independent and combined effects of lifestyle changes and statin treatment on soluble markers of atherosclerotic activity.


METHODS
The study was a randomised, 2 x 2 factorial 1 year intervention trial. Participants (n=177) were sedentary, drug-treated, hypertensive men (aged 40-74 years). They were randomised to placebo, lifestyle intervention (diet and physical activity), fluvastatin 40 mg, or the combination of lifestyle and fluvastatin.


RESULTS
Lifestyle intervention significantly reduced intercellular adhesion molecule-1 (sICAM-1) compared to usual care (p=0.003). Thrombomodulin level remained higher among individuals receiving lifestyle intervention (p=0.025). sICAM-1 was less reduced among fluvastatin treated participants compared to the placebo treated (p=0.029). Changes of blood pressure, weight or waist circumference were not significantly different between treatment groups. Individuals who achieved improvement of classical risk factors also had a significant reduction of endothelial markers (E-selectin, von Willebrands factor, tissue plasminogen activator antigen).


CONCLUSIONS
One year of lifestyle intervention reduced the level of sICAM-1 in sedentary, drug-treated hypertensives, in spite of no impact on traditional risk factors. Low dose fluvastatin had no beneficial effect on the measured markers.
Hjelstuen
Anne
A
Research Forum, Ullevål University Hospital, Oslo, Norway. anne@hjelstuen.no
Anderssen
Sigmund A
SA
Holme
Ingar
I
Seljeflot
Ingebjørg
I
Klemsdal
Tor Ole
TO
D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000175:diagnosis / Q000188:drug therapy*; D015415:Biomarkers; D019483:Disintegrins / Q000494:pharmacology* / Q000627:therapeutic use; D016232:Endothelins / Q000187:drug effects; D005260:Female; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D007249:Inflammation; D018799:Intercellular Adhesion Molecule-1; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D015415:Biomarkers; D019483:Disintegrins; D016232:Endothelins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C102800:flavostatin; D018799:Intercellular Adhesion Molecule-1