Sustained Improvement of Arterial Stiffness and Blood Pressure after Long-Term Rosuvastatin Treatment in Patients with Inflammatory Joint Diseases: Results from the RORA-AS Study.
OBJECTIVE
Patients with inflammatory joint diseases (IJD) have a high prevalence of hypertension and increased arterial stiffness. The aim of the present study was to evaluate the effect of long-term rosuvastatin treatment on arterial stiffness, measured by augmentation index (AIx) and aortic pulse wave velocity (aPWV), and blood pressure (BP) in IJD patients with established atherosclerosis.


METHODS
Eighty-nine statin naïve IJD patients with carotid atherosclerotic plaque(s) (rheumatoid arthritis n = 55, ankylosing spondylitis n = 23, psoriatic arthritis n = 11) received rosuvastatin for 18 months to achieve low-density lipoprotein cholesterol goal ≤1.8 mmol/L. Change in AIx (ΔAIx), aPWV (ΔaPWV), systolic BP (ΔsBP) and diastolic BP (ΔdBP) from baseline to study end was assessed by paired samples t-tests. Linear regression was applied to evaluate associations between cardiovascular disease (CVD) risk factors, rheumatic disease specific variables and medication, and ΔAIx, ΔaPWV, ΔsBP and ΔdBP.


RESULTS
AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end. The mean (95%CI) changes were: ΔAIx: -0.34 (-0.03, -0.65)% (p = 0.03), ΔaPWV: -1.69 (-0.21, -3.17) m/s2 (p = 0.03), ΔsBP: -5.27 (-1.61, -8.93) mmHg (p = 0.004) and ΔdBP -2.93 (-0.86, -5.00) mmHg (p = 0.01). In linear regression models, ∆aPWV was significantly correlated with ΔsBP and ΔdBP (for all: p<0.001).


CONCLUSIONS
There is an unmet need of studies evaluating CVD prevention in IJD patients. We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD. These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins.


BACKGROUND
ClinicalTrials.gov NCT01389388.
Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Eirik
E
Ikdahl
Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Silvia
S
Rollefstad
Section of Vascular Investigations, Oslo University Hospital Aker, Oslo, Norway.
Jonny
J
Hisdal
Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Inge C
IC
Olsen
Centre of Preventive Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
Terje R
TR
Pedersen
Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Tore K
TK
Kvien
Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Anne Grete
AG
Semb
D000368:Aged; D001011:Aorta / Q000187:drug effects / Q000378:metabolism; D015535:Arthritis, Psoriatic / Q000188:drug therapy / Q000378:metabolism; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000378:metabolism; D050197:Atherosclerosis / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007249:Inflammation / Q000188:drug therapy*; D007592:Joint Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods; D012307:Risk Factors; D000068718:Rosuvastatin Calcium / Q000627:therapeutic use*; D013167:Spondylitis, Ankylosing / Q000188:drug therapy / Q000378:metabolism; D059289:Vascular Stiffness / Q000187:drug effects*
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000068718:Rosuvastatin Calcium