The influence of atorvastatin on walking performance in peripheral arterial disease.
BACKGROUND
Recently it has been shown that statins can improve walking distance in patients with peripheral arterial disease. We examined whether statins used in moderate dosages with the aim of reaching the target levels for hypercholesterolemia could improve walking performance in patients with peripheral arterial disease.


METHODS
37 patients with hypercholesterolemia (LDL cholesterol = 3.46 +/- 0.13 mmol/l), who had previously not been treated by statins, were randomized in a double-blind study to a group receiving either atorvastatin at 20 mg/day (N = 20) or placebo (N = 17). All patients had stable intermittent claudication (Fontaine class IIa or IIb). At baseline, after one and three months the pain-free walking distance was measured in all patients.


RESULTS
After 3 months patients in the treated group had reached target cholesterol values (LDL cholesterol = 2,34 +/- 0.9 mmol/l), whereas no significant change in lipids was observed in the control group. The ankle-brachial pressure index (ABPI) did not change significantly in either group. After 3 months the pain-free walking distance was increased significantly (p < 0.001), but similarly in both groups (at entry: 56 (53-108) m vs 53 (53-106) m; after 3 months: 79 (53-108) m vs 106 (66-159) m, for the treated and placebo group, respectively). Therefore this effect had to be attributed to regular exercise and not to statin use.


CONCLUSIONS
Our results show that routine treatment with statin (atorvastatin 20 mg/day), which is effective in reducing the level of cholesterol, does not produce an improvement in walking performance in patients with peripheral arterial disease.
Bregar
U
U
Department of Vascular Disease, University of Ljubljana Medical Centre, Ljubljana, Slovenia.
Poredos
P
P
Sabovic
M
M
Jug
B
B
Sebestjen
M
M
D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood; D003131:Combined Modality Therapy; D018752:Diet, Fat-Restricted; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D007383:Intermittent Claudication / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage* / Q000009:adverse effects; D018709:Statistics, Nonparametric; D016138:Walking
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin