The Short-term Effect of Atorvastatin on Flow-Mediated Vasodilation, Pulse Wave Velocity and Carotid Intima-Media Thickness in Patients With Moderate Cholesterolemia

Background and Objectives: The mechanism for the improved endothelial function after treatment with statins has been shown to be the increased bioavailability of nitric oxide, which is independent of the cholesterol-lowering effects of statin therapy. The aim of this study was to evaluate the short-term effect on flow-mediated vasodilation (FMD), the pulse wave velocity (PWV) and the carotid intima-media thickness (IMT) of statin treatment, as based on the dose and duration of therapy. Subjects and Methods: We enrolled 51 patients with moderate cholesterolemia (total cholesterol: 200-250 mg/dL). The patients were randomly divided into two groups according to the dose of atorvastatin (10 mg: 27 patients, 40 mg: 24 patients). We measured the FMD of the brachial artery, the carotid-radial PWV, the IMT of both common carotid arteries, the lipid profile and the serum C-reactive protein (CRP) at baseline, one week and eight weeks after statin treatment. Results: The total cholesterol and low density lipoprotein (LDL) cholesterol levels in both groups were significantly decreased one week and eight weeks later. However, a difference between the groups was only noted at eight weeks. The FMD for both groups was significantly increased at one and eight weeks; however, the difference was not significantly different between the two groups. The carotid-radial PWV of the 40 mg group was decreased at one and eight weeks, and the change of the PWV at eight weeks was significantly different between the two groups. However, the change in the PWV was not correlated with a change in the LDL-cholesterol. Conclusion: Early improvement of the FMD and PWV following statin treatment might be related to the dose and duration of statin therapy and these effects of statin treatment may be independent of lipid lowering. (Korean Circ J 2008;38:144-151)