Atorvastatin can delay arterial stiffness progression in hemodialysis patients

Abstract

Purpose Arterial stiffness is one of the vascular pathologies in hemodialysis (HD) patients with increased cardiovascular mortality and morbidity. Few approaches have been tested to reduce arterial stiffness in patients with chronic kidney disease (CKD). We aimed to assess effects of atorvastatin on arterial stiffness in hemodialysis patients. Methods This research is a double-blinded, placebo-controlled, randomized clinical trial which included 50 patients maintained on regular HD. Patients were allocated to receive 10 mg atorvastatin or placebo for 24 weeks. Aortic pulse wave velocity (PWV) as an index of large artery stiffness and augmentation index (AIx) as an index of wave reflections were assessed at baseline and after 6 months in both groups. Results In atorvastatin group at study end, there was no significant difference from baseline findings in aortic PWV (7.86 ± 2.5 vs 7.88 ± 2.6 m/sec; p = 0.136), AIx (26.04 ± 8.5 vs 26.0 ± 8.6%; p = 0.714) and central pulse pressure (PP) (p = 1.0). On the other hand, in placebo group after 24 weeks, aortic PWV (7.80 ± 2.16 vs 7.63 ± 2.1 m/sec; p < 0.001), AIx (25.88 ± 9.4 vs 25.04 ± 9.4%; p < 0.001) increased significantly from baseline measurements but central pulse pressure (PP) (p = 0.870) did not. Also, the change (Δ) in aortic PWV and AIx was significantly higher than the change in the atorvastatin group with p value of < 0.001 and < 0.001, respectively. Conclusions Arterial stiffness parameters remained stable in atorvastatin group but increased significantly in placebo-treated patients suggesting a potential role for atorvastatin to delay arterial stiffness progression in HD patients. Larger randomized clinical trials are needed to confirm these findings. Clinical Trials registration ClinicalTrials.gov NCT04472637.

Effects of Long-Term Intervention with Losartan, Aspirin and Atorvastatin on Vascular Remodeling in Juvenile Spontaneously Hypertensive Rats

“…Although various statins improve arterial stiffness [ 22 ], however, it seems beneficial vascular protection of atorvastatin is at least partly independent of lowing cholesterol. Firstly, atorvastatin improves carotid–femoral pulse wave velocity (PWV) in non-hyperlipidemia patients, including type 2 diabetes [ 25 ], coronary artery disease [ 74 ], systemic lupus erythematosus [ 75 ], chronic kidney disease [ 76 ]. Secondly, atorvastatin also decreases C-reactive protein (hsCRP) and osteoprotegerin (OPG) [ 25 ], vascular endothelial grow factor (VEGF), and sVCAM-1, as well as increases C3 complement [ 75 ].…”