title: The differential effect of statins on oxidative stress and endothelial function: atorvastatin versus pravastatin.
abstract: BACKGROUND
  Atherogenic risk in subjects with metabolic syndrome is partly mediated by increased oxidative stress and subsequent endothelial dysfunction. Clinical trials have demonstrated differences in outcomes between subjects receiving lipophilic statins (atorvastatin) compared with hydrophilic statins (pravastatin). However, whether these findings are attributable to differences in the doses administered or to nonlipid-lowering pleiotropic effects of statins on oxidative stress and vascular function remains unknown. We hypothesized that equipotent doses of these two statins will have divergent effects on markers of oxidative stress and endothelial function.
  
  
  METHODS
  Thirty-six subjects with hyperlipidemia and metabolic syndrome and/or diabetes were randomized in a double-blind manner to either pravastatin 80 mg or atorvastatin 10 mg daily. Oxidative stress (dROMs assay that measures lipid hydroperoxides, plasma thiobarbituric acid reactive substances [TBARS], and aminothiol levels) and brachial artery flow-mediated dilation (FMD) were measured at baseline and after 12 weeks of statin therapy.
  
  
  RESULTS
  Statin therapy reduced serum low-density lipoprotein cholesterol levels equally in both groups. Atorvastatin therapy was associated with a significant reduction in TBARS (P = .006) and dROMs levels (P = .02), which was not observed in subjects treated with pravastatin. Endothelial function improved with statin therapy (P = .02), but there was no difference between the statin groups.
  
  
  CONCLUSIONS
  In hyperlipidemic subjects with metabolic syndrome, atorvastatin is associated with a greater reduction in lipid markers of oxidation compared with pravastatin. Whether these effects are responsible for the outcome differences in trials comparing these agents needs further investigation.
authors.affiliation: Emory University School of Medicine, 1364 Clifton Road, Suite D403C, Atlanta, GA 30322, USA. jmurrow@emory.edu
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Murrow
authors.forename: Salman
authors.initials: S
authors.lastname: Sher
authors.forename: Sarfraz
authors.initials: S
authors.lastname: Ali
authors.forename: Irina
authors.initials: I
authors.lastname: Uphoff
authors.forename: Riyaz
authors.initials: R
authors.lastname: Patel
authors.forename: Marcus
authors.initials: M
authors.lastname: Porkert
authors.forename: Ngoc-Anh
authors.initials: NA
authors.lastname: Le
authors.forename: Dean
authors.initials: D
authors.lastname: Jones
authors.forename: Arshed A
authors.initials: AA
authors.lastname: Quyyumi
mesh_terms: D000328:Adult; D000924:Anticholesteremic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000069059:Atorvastatin; D001916:Brachial Artery / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D003553:Cystine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005978:Glutathione / Q000097:blood; D006538:Heptanoic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D017035:Pravastatin / Q000494:pharmacology / Q000627:therapeutic use*; D011758:Pyrroles / Q000494:pharmacology / Q000627:therapeutic use*; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D016896:Treatment Outcome; D014664:Vasodilation
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D017392:Thiobarbituric Acid Reactive Substances; D003553:Cystine; D000069059:Atorvastatin; D005978:Glutathione; D017035:Pravastatin