The effects of treatment with atorvastatin versus rosuvastatin on endothelial dysfunction in patients with hyperlipidaemia

Abstract

SummaryIntroductionStatins can reduce cardiovascular events and improve endothelial function. However, differences in the effect of statins on endothelial dysfunction have not been researched sufficiently. Here, we aimed to compare the effects of atorvastatin versus rosuvastatin on endothelial function via flow–mediated and endothelial–independent dilation. MethodsHyperlipidaemic subjects on treatment with statins for one year (either 20 mg/day atorvastatin or 10 mg/day rosuvastatin) were enrolled in the study. In accordance with the literature, flow–mediated dilation (FMD) and nitrate–mediated endothelium–independent dilation (EID) were measured by ultrasonography on the right brachial artery of each subject. Baseline and final measurements were compared in each group and between the groups.ResultsOne hundred and four subjects (50 atorvastatin and 54 rosuvastatin users) were enrolled in the study. Fifty–eight subjects were female. The groups were statistically similar in terms of age and body mass index, and haemoglobin, creatinine, total cholesterol, triglyceride, high–density lipoprotein and low–density lipoprotein cholesterol levels. In each group, the mean final FMD and EID values were higher compared to their respective baseline values, but the mean changes in FMD and EID were statistically similar in both groups (p = 0.958 for FMD and 0.827 for EID). There was no statistically significant difference between the atorvastatin and rosuvastatin groups in terms of final FMD and EID values (p = 0.122 and 0.115, respectively). ConclusionThis study demonstrated that both one–year atorvastatin and rosuvastatin treatments significantly improved endothelial function, when assessed with FMD and EID and measured by ultrasonography. However, the amount of improvement in endothelial dysfunction was similar in the two treatments.

LDL cholesterol is associated with systemic vascular resistance and wave reflection in subjects naive to cardiovascular drugs

“…Therefore, the consequence of impaired endothelium-mediated dilatation in the resistance vessels would be the elevation of SVR. Twelve month treatment with statins improved flow-mediated dilatation in the brachial artery [25], while a meta-analysis reported increased flow-mediated dilatation following treatment with pitavastatin [26].…”

“…As the deleterious effect of LDL-C on endothelial dysfunction can be reversed by statins, this provides a potential explanation for the beneficial effects of these agents on BP [20,[24][25][26]. Experimental evidence suggests that LDL-C can increase the angiotensin II type 1 receptor density in the arterial wall [15,17], while statin treatment in vivo can reduce the vasoconstrictor responses elicited by angiotensin II in isolated human internal thoracic artery segments in vitro [47].…”

“…LDL-C can reduce nitric oxide bioavailability and blunt the vasodilator response to acetylcholine [4,[14][15][16][17], and the resulting endothelial dysfunction could be manifested as increased BP. Following treatment with statins, several trials have shown moderate but statistically significant lowering effect on BP [18][19][20][21][22][23], reduction of arterial stiffness [19,20,24], and improved endothelial function [25,26].…”

Association of YKL-40 with endothelial dysfunction in patients with essential hypertension

“…Both 1-year atorvastatin and rosuvastatin treatments significantly improved endothelial function, when assessed with FMD and measured by ultrasonography. 5 Jafari et al and Jafari and Mohsenin 6,7 reported that there was…”

“…Both 1-year atorvastatin and rosuvastatin treatments significantly improved endothelial function, when assessed with FMD and measured by ultrasonography. 5 Jafari et al and Jafari and Mohsenin 6,7 reported that there was a significantly inverse correlation between YKL-40 and FMD in hypertensive obstructive sleep apnea (H-OSA) and obstructive sleep apnea (OSA) patients. 6 Serum pentraxin-3 levels are closely related with the measures of indirect noninvasive evaluation methods (FMD) in both dipper and non-dipper hypertension patients.…”