The Early Effect of Lipid-lowering Treatment on Carotid and Femoral Intima Media Thickness (IMT)

Youssef, F. Ben; Seifalian, Alexander M.; Jagroop, IA; Myint, Fiona; Baker, DM; Mikhailidis, D.P.; Hamilton, George

doi:10.1053/ejvs.2002.1611

Cited by 69 publications

(51 citation statements)

References 40 publications

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“…In studies with statins, which are believed to ameliorate the prognosis and development of atherosclerosis by modifying the underlying inflammatory process, short-term treatments have decreased markers of systemic inflammation [28] and have reduced atherosclerosis [29] as well as improved endothelial function in vitro [30] and in vivo [31,32,33]. Treatment of rheumatoid arthritis with etanercept, at the doses used in this study, provides clinical improvement within 2 weeks [34] as well as a decrease in systemic inflammatory markers [35].…”

Section: Discussionmentioning

confidence: 99%

Metabolic and Vascular Effects of Tumor Necrosis Factor-α Blockade with Etanercept in Obese Patients with Type 2 Diabetes

et al. 2005

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Objective: The pro-inflammatory cytokine tumor necrosis factor-α (TNF-α) impairs insulin action in insulin-sensitive tissues, such as fat, muscle and endothelium, and causes endothelial dysfunction. We hypothesized that TNF-α blockade with etanercept could reverse vascular and metabolic insulin resistance. Method and Results: Twenty obese patients with type 2 diabetes were randomized to etanercept treatment (25 mg subcutaneously twice weekly for 4 weeks) or used as controls in an open parallel study. Forearm blood flow and glucose uptake were measured during intra-arterial infusions of serotonin, sodium nitroprusside and insulin co-infused with serotonin. β-Cell function was assessed with oral and intra-venous glucose tolerance tests and whole-body insulin sensitivity by hyperinsulinemic euglycemic clamps. Plasma levels of C-reactive protein and interleukin-6 decreased significantly with etanercept (C-reactive protein from 9.9 ± 3.1 to 4.8 ± 1.4 mg l^–1, p = 0.04; interleukin-6 from 3.1 ± 0.4 to 1.9 ± 0.2 ng l^–1, p = 0.03). Vasodilatory responses to serotonin and sodium nitroprusside infusions remained unchanged. Insulin effect on vasodilatation and on whole-body and forearm glucose uptake remained unchanged as well. β-Cell function tended to improve. Conclusion: Although short-term etanercept treatment had a significant beneficial effect on systemic inflammatory markers, no improvement of vascular or metabolic insulin sensitivity was observed.

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Section: Discussionmentioning

confidence: 99%

Metabolic and Vascular Effects of Tumor Necrosis Factor-α Blockade with Etanercept in Obese Patients with Type 2 Diabetes

et al. 2005

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“…[12][13][14] There are now several reports on the effects of statins (mainly atorvastatin and simvastatin) on renal function and SUA levels as well as their contribution to CHD risk reduction. 8,9,[15][16][17][18][19] ACEIs (Group A and C) had a neutral effect on renal function and SUA levels ( Table 2). These differences in renal function may have influenced the RRRs.…”

Section: Discussionmentioning

confidence: 99%

Effect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart disease

et al. 2004

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We assessed the 'synergy' of statins and angiotensinconverting enzyme inhibitors (ACEI) in reducing vascular events in patients with coronary heart disease (CHD). The GREek Atorvastatin and CHD Evaluation (GREACE) Study, suggested that aggressive reduction of low density lipoprotein cholesterol to 2.59 mmol/l (o100 mg/dl) significantly reduces morbidity and mortality in CHD patients, in comparison to undertreated patients. In this post hoc analysis of GREACE the patients (n ¼ 1600) were divided into four groups according to long-term treatment: Group A (n ¼ 460 statin þ ACEI), B (n ¼ 420; statin, no ACEI), C (n ¼ 371;no 371;no statin, on ACEI), and D (n ¼ 349; no statin, no ACEI). Analysis of variance was used to assess differences in the relative risk reduction (RRR) in 'all events' (primary end point) between groups. During the 3-year follow-up there were 292 cardiovascular events; 45 (10% of patients) in group A, 61 (14.5%) in group B, 91 in group C (24.5%) and 95 events in group D (27%). The RRR (95% confidence interval (CI) in the primary end point in group A was 31%, (95% CI À48 to À6%, P ¼ 0.01) in comparison to group B, 59% (95% CI À72 to À48%, Po0.0001) to group C and 63% (95% CI À74 to À51%, Po0.0001) to group D. There was no significant difference in RRR between groups C and D (9%, CI À27-10%, P ¼ 0.1). Other factors (eg the blood pressure) that can influence clinical outcome did not differ significantly between the four treatment groups. In conclusion, the statin þ ACEI combination reduces cardiovascular events more than a statin alone and considerably more than an ACEI alone. Aggressive statin use in the absence of an ACEI also substantially reduced cardiovascular events. Treatment with an ACEI in the absence of a statin use reduced clinical events in comparison to patients not treated with an ACEI but not significantly, at least in these small groups of patients.

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“…6,36,[38][39][40]53,128 It is also relevant that recent trials have shown that aggressive treatment with statins improves serum creatinine and urate levels. [129][130][131][132][133][134][135][136][137] These findings probably reflect an improved creatinine clearance. In turn, this effect is probably another consequence of improved blood flow following treatment with statins.…”

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confidence: 99%

Statins: another class of antihypertensive agents?

et al. 2006

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The assessment of global cardiovascular risk is an essential step in the management of atherosclerotic disease prevention. Among the risk factors to be addressed are hypertension and hyperlipidaemia; these commonly coexist. A neutral or lipid-friendly antihypertensive agent is probably useful in the presence of lipid abnormalities. Similarly, statins have been shown to decrease cardiovascular risk in hypertensive patients. There is also experimental and clinical evidence that statins have blood pressure (BP)-lowering effects. In this review, we discuss the beneficial effects of statins on BP, and provide an overview of the underlying pathophysiology. We also consider the evidence justifying the use of statins in the management of hypertensive patients.

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The Early Effect of Lipid-lowering Treatment on Carotid and Femoral Intima Media Thickness (IMT)

Cited by 69 publications

References 40 publications

Metabolic and Vascular Effects of Tumor Necrosis Factor-α Blockade with Etanercept in Obese Patients with Type 2 Diabetes

Metabolic and Vascular Effects of Tumor Necrosis Factor-α Blockade with Etanercept in Obese Patients with Type 2 Diabetes

Effect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart disease

Statins: another class of antihypertensive agents?

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