阿托伐他汀小剂量对高血压合并高脂血症患者动脉僵硬度和中心动脉压增强的影响。
Effects of low-dose atorvastatin on arterial stiffness and central aortic pressure augmentation in patients with hypertension and hypercholesterolemia.
机构信息
Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA University Hospital, Thessaloniki, Greece.
出版信息
Am J Hypertens. 2013 May;26(5):608-16. doi: 10.1093/ajh/hps098. Epub 2013 Feb 28.
BACKGROUND
Experimental and clinical data suggest that statins exert anti-inflammatory and antiproliferative actions on vasculature beyond their lipid-lowering properties. Whether these pleiotropic effects of statins translate into a beneficial effect on arterial stiffness is not clear. This study aimed to evaluate the potential effects of low-dose atorvastatin treatment on arterial stiffness and central arterial pressure waveforms in patients with mild hypertension and hypercholesterolemia.
METHODS
In a double-blind, randomized, placebo-controlled fashion, 50 hypertensive and hypercholesterolemic patients were allocated to receive 10 mg of atorvastatin or placebo for 26 weeks. Arterial stiffness was assessed by aortic pulse-wave velocity (PWV) using a Sphygmocor device. Central arterial pressure waveform parameters were estimated by radial artery applanation tonometry. Heart rate-adjusted augmentation index (AIx(75)) was used as measure of wave reflections.
RESULTS
At study end, aortic PWV (9.0 ± 1.5 vs. 10.9 ± 2.6 m/sec; P < 0.001) and AIx(75) (24.9% ± 9.7% vs 28.8% ± 11.8%; P < 0.001) were significantly lower in the atorvastatin group than that placebo group. Furthermore, decreases in central aortic systolic blood pressure and pulse pressure were evident at study-end with atorvastatin but not with placebo (130 ± 8 vs. 138 ± 6 mm Hg, P < 0.001; 48 ± 7 vs. 53 ± 6 mm Hg, P < 0.05, respectively). Atorvastatin-induced reductions in aortic PWV during follow-up showed significant associations with changes in AIx(75) and central aortic systolic blood pressure and pulse pressure.
CONCLUSIONS
This study shows that low-dose atorvastatin treatment improves arterial stiffness and exerts a reduction on central aortic pressures. These effects may represent a potential mechanism of cardiovascular risk reduction observed with statin use.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov Database Identifier Number: NCT01126684.
背景
实验和临床数据表明，他汀类药物除了具有降低血脂的特性外，还对血管发挥抗炎和抗增殖作用。这些他汀类药物的多效性作用是否对动脉僵硬度有有益影响尚不清楚。本研究旨在评估小剂量阿托伐他汀治疗对轻度高血压和高胆固醇血症患者动脉僵硬度和中心动脉压波形的潜在影响。
方法
采用双盲、随机、安慰剂对照的方法，将 50 例高血压和高胆固醇血症患者分为阿托伐他汀 10mg 组或安慰剂组，治疗 26 周。采用 Sphygmocor 装置测量主动脉脉搏波速度（PWV）评估动脉僵硬度。通过桡动脉平板张力测量法估计中心动脉压波形参数。心率校正后的增强指数（AIx（75））用于衡量波反射。
结果
研究结束时，阿托伐他汀组的主动脉 PWV（9.0±1.5 比 10.9±2.6 m/sec；P<0.001）和 AIx（75）（24.9%±9.7%比 28.8%±11.8%；P<0.001）明显低于安慰剂组。此外，阿托伐他汀治疗后中心主动脉收缩压和脉压下降（130±8 比 138±6mmHg，P<0.001；48±7 比 53±6mmHg，P<0.05）。阿托伐他汀治疗期间主动脉 PWV 的降低与 AIx（75）、中心主动脉收缩压和脉压的变化呈显著相关。
结论
本研究表明，小剂量阿托伐他汀治疗可改善动脉僵硬度并降低中心主动脉压。这些作用可能代表了他汀类药物应用观察到的心血管风险降低的潜在机制。
临床试验注册
ClinicalTrials.gov 数据库标识符编号：NCT01126684。
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