Document Detail


Atorvastatin treatment is associated with less augmentation of the carotid pressure waveform in hypertension: a substudy of the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT).
MedLine Citation:
PMID:  19720956     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hydroxymethylglutaryl-CoA reductase inhibitors (statins) reduce cardiovascular events in hypertensive subjects, but their effect on carotid BP, pressure augmentation, and wave reflection is unknown. We compared the effect of atorvastatin with placebo in a substudy of the lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA). Hypertensive patients (n=142; age=43 to 79 years; 127 male) with total cholesterol < or = 6.5 mmol/L were randomized to atorvastatin 10 mg or placebo. Carotid BP and flow velocity were measured by tonometry and Doppler ultrasound. Augmentation index (carotid AI(x)) was calculated, and waveforms were separated into backward and forward components by wave intensity analysis. Brachial BP was similar in atorvastatin and placebo groups. Carotid AI(x) and augmentation pressure were significantly less in patients randomized to atorvastatin (mean [SD]: 21.7 [12.1] versus 25.9 [10.3] %; P=0.027 and 10.2 [6.5] versus 13.1 [6.6] mm Hg; P=0.016, respectively), and atorvastatin treatment was associated with significantly less wave reflection from the body. Carotid systolic BP was slightly lower in the atorvastatin group, but there was a statistically significant interaction between lipid-lowering and antihypertensive regimen with lower carotid systolic BP in patients randomized to amlodipine-based therapy and atorvastatin. Carotid wave velocity, timings of waves, and wave intensities did not differ significantly between atorvastatin and placebo groups. Atorvastatin treatment is associated with less augmentation of the carotid BP waveform and less wave reflection from the body. This could contribute to the reduction in risk of cardiovascular events by statins.
Authors:
Charlotte Manisty; Jamil Mayet; Robyn J Tapp; Peter S Sever; Neil Poulter; Simon A McG Thom; Alun D Hughes;
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-08-31
Journal Detail:
Title:  Hypertension     Volume:  54     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-22     Completed Date:  2009-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1009-13     Citation Subset:  IM    
Affiliation:
International Centre for Circulatory Health, Imperial College London & Imperial College Healthcare NHS Trust, London W2 1LA, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amlodipine / therapeutic use
Ankle Brachial Index
Anticholesteremic Agents / therapeutic use*
Antihypertensive Agents / therapeutic use*
Blood Pressure Determination
Carotid Arteries / drug effects*,  physiology
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Female
Great Britain
Heptanoic Acids / therapeutic use*
Humans
Hypertension / diagnosis,  drug therapy*
Male
Middle Aged
Multivariate Analysis
Probability
Prospective Studies
Pulsatile Flow / drug effects
Pyrroles / therapeutic use*
Reproducibility of Results
Scandinavia
Severity of Illness Index
Vasodilator Agents / therapeutic use
Grant Support
ID/Acronym/Agency:
//Wellcome Trust
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Antihypertensive Agents; 0/Heptanoic Acids; 0/Pyrroles; 0/Vasodilator Agents; 110862-48-1/atorvastatin; 88150-42-9/Amlodipine
Comments/Corrections
Comment In:
Hypertension. 2009 Nov;54(5):958-9   [PMID:  19720953 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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