Statin treatment improves cerebral more than systemic endothelial dysfunction in patients with arterial hypertension.
BACKGROUND
The pleiotropic effects of statins on the endothelial function are well recognized. However, the effect of statins might not be equally pronounced in the cerebral and systemic circulation. We compared cerebral and systemic endothelial function by L-arginine cerebrovascular reactivity and flow-mediated dilatation (FMD), respectively, in patients with arterial hypertension (AH) and healthy controls before and after atorvastatin treatment.


METHODS
L-arginine reactivity and FMD were measured in patients with AH (29 patients, aged 61.1 +/- 6.2 years) and 21 healthy controls. The mean arterial velocity (v(m)) in both middle cerebral arteries was measured by transcranial Doppler sonography before, during, and after a 30-min intravenous infusion of L-arginine. FMD of the brachial artery after hyperemia was determined. The measurements were repeated after 3 months of treatment with atorvastatin.


RESULTS
L-arginine reactivity and FMD were decreased in patients with AH (12.5 +/- 8.7%; 2.7 +/- 5.0 %) compared with controls (21.3 +/- 10.9%; 8.5 +/- 5.9%) (P < 0.01). After atorvastatin treatment, L-arginine reactivity and FMD improved in patients with AH (19.5 +/- 10.6%; 4.6 +/- 4.1%) compared with the controls (20.2 +/- 10.2%; 9.7 +/- 3.9%). The use of statin restored the cerebral circulation reactivity, while there was little change in the systemic circulation measured by FMD.


CONCLUSIONS
The decreased L-arginine reactivity and FMD were found to improve after atorvastatin treatment in patients with AH, but the results suggest that statin therapy improved cerebral more than systemic endothelial function.
Pretnar-Oblak
Janja
J
Department of Neurology, Ljubljana Medical Center, Ljubljana, Slovenia. janja.pretnar@kclj.si
Sebestjen
Miran
M
Sabovic
Miso
M
D001120:Arginine / Q000494:pharmacology; D000069059:Atorvastatin; D001775:Blood Circulation / Q000187:drug effects*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000627:therapeutic use; D017585:Ultrasonography, Doppler, Transcranial
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D001120:Arginine; D000069059:Atorvastatin