Inhibitory Effects of Micronized Fenofibrate on Carotid Atherosclerosis in Patients with Essential Hypertension

Abstract

Background:The coexistence of hypertension and dyslipidemia synergistically increases the risk of cardiovascular events. We investigated the effect of the lipidlowering agent micronized fenofibrate on inhibition of carotid atherosclerosis in patients with essential hypertension and mild hyperlipidemia. Methods: We measured serum lipid profiles and inflammatory markers on chemistry or immune analyzers and common or internal carotid intima-media thickness (IMT) and diameter (D) by ultrasonography.Results: Patients receiving micronized fenofibrate for 24 months in addition to antihypertensive treatment had decreased concentrations of total cholesterol, LDLcholesterol, triglyceride, apolipoprotein B100, oxidized LDL, high-sensitivity C-reactive protein, P-selectin, and cytokines. These patients had increased concentrations of HDL-cholesterol, apolipoprotein A-I, and nitric oxide. Common carotid artery IMT (CCAIMT) and internal carotid artery IMT (ICAIMT) remained unchanged during the 24-month intervention. Moreover, the mean CCAIMT/D ratio and ICAIMT/D ratio were significantly decreased in the fenofibrate intervention group. In contrast, CCAIMT/D and ICAIMT/D ratios were increased in the control group. The incidence rates of carotid artery plaque formation and stroke in the fenofibrate intervention group were significantly lower than those in the control group.

Relationship between Carotid Atherosclerosis and Lumbar Spine Bone Mineral Density in Postmenopausal Women

“…Furthermore, in the LIPID Atherosclerosis Substudy (31), pravastatin reduced the carotid IMT in subjects with coronary heart disease. Zhu et al (32) have demonstrated that micronized fenofibrate inhibits the progression of carotid IMT in patients with hypertrigryceridemia and essential hypertension. Katakami et al (33) have shown that gliclazide attenuates progression of carotid IMT in subjects with type 2 diabetes.…”

Long-Term Effects of Fenofibrate on Carotid Intima-Media Thickness and Augmentation Index in Subjects With Type 2 Diabetes Mellitus

“…In DAIS (Diabetes Atherosclerosis Intervention Study), fenofibrate slowed progression of coronary atherosclerosis but did not significantly reduce cardiac end points (14). Studies with carotid intima-media thickness (IMT) as a surrogate end point have produced inconsistent results: one with slower progression of carotid atherosclerosis in patients on fenofibrate compared with placebo (15) and one with no effect of bezafibrate on IMT (16), whereas another study reported progression of atherosclerosis in patients on different fibrates compared with those on statins (17).…”

Dyslipidemia aterogenna w codziennej praktyce — interdyscyplinarny konsensus polskich ekspertów

“…Opublikowana w 2015 roku analiza oparta na badaniu Framingham pokazała, że w ciągu 9-letniej prospektywnej obserwacji pacjentów nieobciążonych IS lub TIA HDL-C nie większe niż 40 mg/dl było związane z podwyższonym ryzykiem udaru niedokrwiennego ([95% CI] 1,59 [1,23-2,05]; p < 0,001), natomiast stężenie TG nie wpływało na ryzyko IS [53]. Badanie to potwierdziło wcześniejsze analizy, według których na każdy wzrost stężenia HDL-C o 1 mmol/l ryzyko IS zmniejsza się rocznie o 11-15% [10].…”