Influence of atorvastatin on blood pressure control in treated hypertensive, normolipemic patients – An open, pilot study

Kuklinska, Agnieszka M.; Mroczko, Barbara; Musiał, Włodzimierz J.; Sawicki, Robert; Kozieradzka, Anna; Usowicz-Szaryńska, Monika; Kamiński, Karol; Knapp,; Szmitkowski, Maciej

doi:10.3109/08037050903576726

Cited by 17 publications

(20 citation statements)

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“…As shown in Table 1, these pharmacological interventions reduce levels of TNF-␣, monocyte chemotactic protein-1, and nitrotyrosine, suggesting that treatments conferring both anti-inflammatory and antioxidant benefits are most effective at improving NO bioavailability and arterial function in OZR. Atorvastatin, for example, has well-defined roles in improving endothelial function, increasing NO bioavailability, and reducing MAP and has anti-inflammatory/ antioxidant effects in addition to its cholesterol-lowering mechanism (11,29).…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome impairs reactivity and wall mechanics of cerebral resistance arteries in obese Zucker rats

Brooks

DeVallance

d’Audiffret

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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-The metabolic syndrome (MetS) is highly prevalent in the North American population and is associated with increased risk for development of cerebrovascular disease. This study determined the structural and functional changes in the middle cerebral arteries (MCA) during the progression of MetS and the effects of chronic pharmacological interventions on mitigating vascular alterations in obese Zucker rats (OZR), a translationally relevant model of MetS. The reactivity and wall mechanics of ex vivo pressurized MCA from lean Zucker rats (LZR) and OZR were determined at 7-8, 12-13, and 16 -17 wk of age under control conditions and following chronic treatment with pharmacological agents targeting specific systemic pathologies. With increasing age, control OZR demonstrated reduced nitric oxide bioavailability, impaired dilator (acetylcholine) reactivity, elevated myogenic properties, structural narrowing, and wall stiffening compared with LZR. Antihypertensive therapy (e.g., captopril or hydralazine) starting at 7-8 wk of age blunted the progression of arterial stiffening compared with OZR controls, while treatments that reduced inflammation and oxidative stress (e.g., atorvastatin, rosiglitazone, and captopril) improved NO bioavailability and vascular reactivity compared with OZR controls and had mixed effects on structural remodeling. These data identify specific functional and structural cerebral adaptations that limit cerebrovascular blood flow in MetS patients, contributing to increased risk of cognitive decline, cerebral hypoperfusion, and ischemic stroke; however, these pathological adaptations could potentially be blunted if treated early in the progression of MetS. metabolic syndrome; cerebrovascular remodeling; arterial stiffness; reactive oxygen species NEW & NOTEWORTHY We describe the temporal development of alterations in wall mechanics and vascular reactivity of middle cerebral arteries of obese Zucker rats through evolution of the metabolic syndrome. While novel, this study is particularly noteworthy, as we also use clinically relevant agents against the metabolic syndrome given from an early age to determine vascular outcomes.THE METABOLIC SYNDROME (MetS), a clustering of metabolic abnormalities such as obesity, impaired glycemic control, atherogenic dyslipidemia, and hypertension, with the additional contributing conditions of a prooxidant, prothrombotic, and proinflammatory state, is prevalent in ϳ56 million adults in the United States (21). Correspondingly, MetS is associated with a threefold increased risk of cardiovascular mortality (21) and a 50% increased risk of stroke (5) and is a known risk factor for cognitive decline with aging (41). It is therefore imperative that translationally relevant models of MetS be effectively interrogated to guide our understanding of the cerebrovascular adaptations that are associated with the development of MetS, its physiological, molecular, and genomic mechanistic underpinnings, and the effectiveness of established and novel therapeutic agents in either blunti...

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Section: Discussionmentioning

confidence: 99%

Metabolic syndrome impairs reactivity and wall mechanics of cerebral resistance arteries in obese Zucker rats

Brooks

DeVallance

d’Audiffret

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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“…[10][11][12] In contrast, studies using ABPM, although fewer in number and still having limitations (short duration of follow-up, small sample sizes), showed significant reductions of about 5/3 mm Hg in 24-h SBP/DBP in hypertensive patients. 22,[24][25][26] Only one recent study with ABPM reported non-significant differences between a statin and placebo; however, that should be rather attributed to the low number of subjects (n ¼ 13) and the short total duration (6 weeks). 27 A meta-analysis of 20 randomized studies of statin therapy, in which background antihypertensive treatment remained unchanged also slightly supported a beneficial effect, showing a significant reduction of 1.9 mm Hg in SBP vs placebo or control hypolipidemic therapy.…”

Section: Discussionmentioning

confidence: 99%

Low-dose atorvastatin reduces ambulatory blood pressure in patients with mild hypertension and hypercholesterolaemia: a double-blind, randomized, placebo-controlled study

et al. 2011

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Among several beneficial cardiovascular actions of statins, experimental studies have suggested that statins may also induce a mild blood pressure (BP) reduction. However, clinical data were controversial and the potential hypotensive statin effect remains uncertain. This study aimed to investigate the effect of atorvastatin on ambulatory BP in patients with mild hypertension and hypercholesterolaemia. A total of 50 patients with mild hypertension and hypercholesterolaemia participated in this double-blind, randomized, placebo-controlled study. Patients were randomized to either 10 mg atorvastatin or placebo for 26 weeks. Background antihypertensive treatment, if any, remained unchanged during follow-up. At baseline and study-end (26 weeks), ambulatory BP monitoring and blood sampling for determination of standard biochemical and safety parameters were performed in all participants. BP loads were defined as the percentage of BP measurements exceeding the hypertension threshold of 140/90 mm Hg for daytime and 125/75 mm Hg nighttime period. Atorvastatin significantly reduced 24-h systolic and diastolic BP (DBP; median (range)) as compared with placebo (-5.0 (-21.0, 4.0) vs +1.0 (-6.0, 7.0) mm Hg, P<0.001 and -3.0 (-16.0, 2.0) vs +0.1 (-7, 4) mm Hg, P<0.01, respectively). Reductions in systolic and DBP loads during follow-up were also evident in the atorvastatin, but not in the placebo group. BP-lowering effects of atorvastatin were consistent in both daytime and nighttime periods. This study shows a mild, but consistent throughout the 24-h period BP-lowering effect of atorvastatin in patients with mild hypertension and hypercholesterolaemia. This beneficial effect of atorvastatin on BP may represent another pathway through which this drug class provides cardiovascular risk reduction.

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“…Nevertheless, the statistically insignificantly changed urinary excretion rates of 2,3-dinor-TxB 2 and 2,3-dinor-6-keto-PGF 1␣ , as well as their molar ratio suggest that the TxA 2 /PGI 2 homeostasis was not altered to a major extent by atorvastatin or placebo in the patients investigated. Literature reports on the effects of atorvastatin on TxA 2 [71][72][73][74][75][76][77][78][79] and PGI 2 [80][81][82][83] synthesis in diabetes are rare and contradictory, presumably because the TxA 2 and PGI 2 synthesis has not been assessed by measuring 2,3-dinor-TxB 2 and 2,3-dinor-6-keto-PGF 1␣ , respectively, as required [41] and has been performed in the present study. It is of particular interest that the urinary excretion of 8-iso-PGF 2␣ correlated considerably with that of 2,3-dinor-TxB 2 but not with the urinary excretion of 2,3-dinor-6-keto-PGF 1␣ , although 2,3-dinor-6-keto-PGF 1␣ correlated with 2,3-dinor-TxB 2 .…”

Section: Thromboxane and Prostacyclin Synthesismentioning

confidence: 99%

No effects of atorvastatin (10mg/d or 80mg/d) on nitric oxide, prostacyclin, thromboxane and oxidative stress in type 2 diabetes mellitus patients of the DALI study

Tsikas

Pham

Suchy

et al. 2015

Pharmacological Research

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Influence of atorvastatin on blood pressure control in treated hypertensive, normolipemic patients – An open, pilot study

Cited by 17 publications

References 20 publications

Metabolic syndrome impairs reactivity and wall mechanics of cerebral resistance arteries in obese Zucker rats

Metabolic syndrome impairs reactivity and wall mechanics of cerebral resistance arteries in obese Zucker rats

Low-dose atorvastatin reduces ambulatory blood pressure in patients with mild hypertension and hypercholesterolaemia: a double-blind, randomized, placebo-controlled study

No effects of atorvastatin (10mg/d or 80mg/d) on nitric oxide, prostacyclin, thromboxane and oxidative stress in type 2 diabetes mellitus patients of the DALI study

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