title: Impaired endothelial function and arterial stiffness in patients with type 2 diabetes - The effect of a very low-dose combination of fluvastatin and valsartan.
abstract: OBJECTIVE
  Patients with type 2 diabetes are at increased cardiovascular risk. The aim was to explore whether the impaired arterial wall characteristics typical of these patients could be improved by the unique beneficial effects of a very low-dose combination of fluvastatin and valsartan (low-flu/val).
  
  
  METHODS
  Forty middle-aged males (50.4±6.1years) with type 2 diabetes were recruited to a double-blind, randomized study. Patients (N=20) received low-flu/val (10/20mg) or placebo (N=20) over 30days in addition to their regular therapy. Brachial artery flow mediated dilation (FMD), common carotid artery pulse wave velocity (PWV) and β-stiffness were assessed before and after treatment, and 3 and 6months after treatment discontinuation. The treatment was then repeated.
  
  
  RESULTS
  Arterial wall characteristics significantly improved. After 30days of intervention, FMD increased from 2.4±0.3 to 4.2±0.3 (p<0.001), PWV decreased from 6.4±0.1 to 5.8±0.2 (p<0.001) and β stiffness decreased from 7.8±0.4 to 6.7±0.4 (p<0.001). Lipids and arterial pressure did not change. After treatment discontinuation, the beneficial effects decreased over the following months. The repetition of treatment completely regained the initial benefits. No changes were observed in the placebo group.
  
  
  CONCLUSIONS
  Low-flu/val added on-top of optimal therapy substantially improves arterial wall characteristics in patients with type 2 diabetes.
authors.affiliation: Department of Vascular Diseases, University Clinical Center Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia.
authors.forename: Maja
authors.initials: M
authors.lastname: Boncelj Svetek
authors.affiliation: Department of Vascular Diseases, University Clinical Center Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Eržen
authors.affiliation: Diabetes & Me, Private Clinic for Diabetes, Židovska 1, 1000 Ljubljana, Slovenia.
authors.forename: Karin
authors.initials: K
authors.lastname: Kanc
authors.affiliation: Department of Vascular Diseases, University Clinical Center Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia. Electronic address: misabovic@gmail.com.
authors.forename: Mišo
authors.initials: M
authors.lastname: Šabovič
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000009:adverse effects; D001158:Arteries / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D004311:Double-Blind Method; D016903:Drug Monitoring; D004359:Drug Therapy, Combination / Q000009:adverse effects; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077340:Fluvastatin; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D014463:Ultrasonography; D000068756:Valsartan / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D059289:Vascular Stiffness / Q000187:drug effects*; D014664:Vasodilation / Q000187:drug effects
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D000077340:Fluvastatin; D000068756:Valsartan
keywords: Arterial wall characteristics; Cardiovascular disease; Clinical trial; Low-flu/val; Type 2 diabetes