One-Month Therapy with Simvastatin Restores Endothelial Function in Hypercholesterolemic Children and Adolescents

Abstract

Simvastatin has been shown to restore endothelial function in children with familial hypercolesterolemia after 28 weeks of treatment. The aim of this study was to evaluate 1-month simvastatin treatment effect on endothelial function in hypercholesterolemic children and adolescents. Eighteen hypercholesterolemic patients (HC group) and 18 healthy controls, aged 6-18 years, were studied with medical history, physical examination, full lipid profile, serum apolipoprotein B (apo B), fibrinogen, hepatic transaminases, and creatine kinase concentrations. Flow-mediated dilatation (FMD) was performed by high-resolution ultrasound of the brachial artery. The HC group received simvastatin 10 mg/day for 1 month. Arterial diameter was measured by two experienced sonographers who were unaware of subjects' conditions. At baseline, FMD was impaired in the HC group (mean, 5.27 +/- 4.67%) compared to controls (mean, 15.05 +/- 5.97%) (p < 0.001). After treatment, we observed a significant reduction in total cholesterol (TC) (29%), low-density lipoprotein cholesterol (LDL-C); (37%), apo B concentrations (36%) and FMD restoration (mean, 12.94 +/- 7.66%), with an absolute increase of 7.66 +/- 8.58 (p = 0.001). These results show that children and adolescents with hypercholesterolemia present endothelial dysfunction, and simvastatin, in addition to significantly reducing TC, LDL-C, and apo B concentrations, restores endothelial function with 1-month treatment.

Avaliação da qualidade de cápsulas de sinvastatina de farmácias magistrais

“…Statins are known to inhibit this enzyme and are effective in reducing triglyceride and low-density lipoprotein (LDL) levels and increasing high-density lipoprotein (HDL) levels, with different lipid-lowering potentials. 22 Statins such as simvastatin present other types of pharmacological activity: anti-infl ammatory action, 10 through improvement of endothelial function; 9 and antioxidant action, 18 through reduction of platelet adhesion and thrombus formation, 19 among other activity. Among the most serious adverse effects is the development of myopathy and rhabdomyolysis or muscle necrosis.…”

I Diretriz Brasileira de Hipercolesterolemia Familiar (HF)

“…Podem diminuir o LDL-c em cerca de 30% e aumentar o HDL-c em 5%, e consequentemente atenuar o espessamento médio-intimal e melhorar a função endotelial [176][177][178][179][180][181] (Classe I, Nível A). Em que pesem essas considerações, não há evidências suficientes para consenso de quando começar estatinas na infância ou qual a meta de LDL-c a ser alcançada nessa faixa etária 182 (Classe IIb, Nível B).…”

Hyperlipidemia, eating disorders, and smoking cessation

“…Ferreira et al [7] reported that simvastatin restores endothelial function in hypercholesterolemic children and adolescents.…”