Atorvastatin reduces arterial stiffness in patients with rheumatoid arthritis

• Published in: Annals of the rheumatic diseases Vol. 63; no. 12; pp. 1571 - 1575
• Main Authors: Van Doornum, S, McColl, G, Wicks, I P
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.12.2004; BMJ; BMJ Publishing Group LTD
• Subjects: 28 joint disease activity score; Adult; Aged; AIx; arterial stiffness; Arteries - drug effects; Arteries - physiopathology; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - physiopathology; Atherosclerosis; Atorvastatin Calcium; augmentation index; Biological and medical sciences; Blood pressure; C reactive protein; Cardiovascular disease; Cholesterol; CRP; DAS28; Disease prevention; Diseases of the osteoarticular system; Drug Evaluation; Elasticity - drug effects; erythrocyte sedimentation rate; ESR; Extended Report; Female; Health risk assessment; Heptanoic Acids - pharmacology; Heptanoic Acids - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Inflammation; Inflammation Mediators - blood; Inflammatory joint diseases; Kinases; LDL; Lipids - blood; low density lipoprotein; Male; Medical sciences; Middle Aged; Mortality; nitric oxide; NNT; number needed to treat; Pulsatile Flow - drug effects; pulse wave analysis; PWA; Pyrroles - pharmacology; Pyrroles - therapeutic use; Radial Artery - drug effects; Radial Artery - physiopathology; Rheumatoid arthritis; Rheumatology; Software; Statins; Studies; Human; Enzyme; Diseases of the osteoarticular system; Enzyme inhibitor; Autoimmune disease; Inflammatory joint disease; Statin derivative; Chronic; Rheumatoid arthritis; Atorvastatin; Hydroxymethylglutaryl-CoA reductase; Stiffness; Oxidoreductases; Antilipemic agent
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2003.018333

Background: Chronic systemic inflammation may contribute to accelerated atherosclerosis and increased arterial stiffness in patients with rheumatoid arthritis (RA). In addition to lowering cholesterol, statins have immunomodulatory effects which may be especially beneficial in patients with RA who have systemic immune activation. Objective: To investigate the effect of atorvastatin on the augmentation index (AIx: a measure of arterial stiffness) and systemic inflammation in RA. Methods: 29 patients with RA (mean (SD) age 55 (13) years) with moderately active disease of long duration were studied. AIx, lipid levels, serum inflammatory markers, and disease activity score were measured before and after 12 weeks of atorvastatin 20 mg daily. Results: AIx improved significantly from 34.1 (11.6)% to 29.9 (11)% (p = 0.0002), with the greatest improvements in AIx occurring in those subjects with the highest disease activity scores (r = −0.5, p = 0.007). Total and LDL cholesterol were reduced from 5.5 (0.9) to 3.9 (0.7) mmol/l and 3.3 (0.8) to 1.9 (0.6) mmol/l, respectively (p = 0.0001). Serum inflammatory markers remained unchanged during the study. Conclusions: Atorvastatin significantly reduced arterial stiffness in patients with RA. The greatest improvements were seen in patients with more active disease, suggesting that, in addition to the beneficial effects of cholesterol reduction, immune modulation may contribute to the cardioprotective effect of statins.