Effect of atorvastatin on endothelium-dependent vasodilation in postmenopausal women with average serum cholesterol levels

• Published in: The American journal of cardiology Vol. 90; no. 7; pp. 747 - 750
• Main Authors: Mercuro, Giuseppe, Zoncu, Sandra, Saiu, Francesca, Sarais, Cristiano, Rosano, Giuseppe M.C
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2002; Elsevier; Elsevier Limited
• Subjects: Acetylcholine; Anticholesteremic Agents - administration & dosage; Anticholesteremic Agents - pharmacology; Anticholesteremic Agents - therapeutic use; Arginine; Atorvastatin; Biological and medical sciences; Brachial Artery - physiology; Cholesterol; Cholesterol - blood; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cross-Over Studies; Double-Blind Method; Drug therapy; Endothelium, Vascular - drug effects; Female; Forearm - blood supply; General and cellular metabolism. Vitamins; Heptanoic Acids - administration & dosage; Heptanoic Acids - pharmacology; Heptanoic Acids - therapeutic use; Humans; Hypercholesterolemia - prevention & control; Medical sciences; Menopause; Middle Aged; Nitroprusside; omega-N-Methylarginine; Pharmacology. Drug treatments; Postmenopause; Pyrroles - administration & dosage; Pyrroles - pharmacology; Pyrroles - therapeutic use; Reference Values; Regional Blood Flow; Treatment Outcome; Vasodilation - drug effects; Vasodilator Agents - administration & dosage; Vasodilator Agents - pharmacology; Vasodilator Agents - therapeutic use; Women; Human; Regional blood flow; Enzyme; Treatment efficiency; Brachial artery; Enzyme inhibitor; Statin derivative; Endothelium; Chemotherapy; Vasomotricity; Treatment; Atorvastatin; Postmenopause; Hydroxymethylglutaryl-CoA reductase; Oxidoreductases; Hemodynamics; Vascular wall
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(02)02602-4

After menopause, most healthy women show an impairment of peripheral vasodilation and an increase of plasma cholesterol levels. Statins have been shown to improve endothelial function in hypercholesterolemic men and women. The present study tests whether atorvastatin (10 mg) influences endothelium-dependent vasodilation in postmenopausal normocholesterolemic women. Twenty-eight healthy, postmenopausal women (mean age 51 ± 2 years) with serum total cholesterol and low-density lipoprotein cholesterol within the desirable range entered a double-blind, single-crossover study. Postmenopausal women were randomized to receive either atorvastatin (10 mg/day) or placebo for 10 days and then crossed to the complementary treatment. Endothelium-dependent and -independent responses were assessed by means of strain-gauge plethysmography before and after intra-arterial infusion of acethylcholine (ACh) and sodium nitroprusside, in comparison to physiologic saline. The nitric oxide pathway was evaluated by repeating the infusion of ACh during admininstration of l-arginine and (G)-monomethyl- l-arginine ( l-NMMA). Serum lipoproteins were not significantly modified by the active treatment. The vasodilation induced by ACh was significantly higher in the atorvastatin-treated women compared with the placebo-treated group (24 ± 3 vs 13 ± 2 ml/100 ml tissue/min, p <0.01). In contrast, responses to the endothelium-independent vasodilator sodium nitroprusside were not significantly modified by atorvastatin. The ACh-stimulated vasodilation induced by atorvastatin was additionally potentiated by l-arginine (800 ± 105% vs 370 ± 60%, p <0.05) and blunted by l-NMMA. No correlation was found between changes in plasma cholesterol and improvement in forearm blood flow. Our data show that the beneficial effect of atorvastatin on endothelium-dependent vasodilation is independent from changes in the lipid profile.