Long-term effects of pravastatin and fosinopril on peripheral endothelial function in albuminuric subjects.

Abstract

The purpose of this double-blind, randomized, placebo-controlled trial was to determine the long-term effects of pravastatin and fosinopril treatment on peripheral endothelial function in subjects with albuminuria. Subjects (mean age 51 years, 63% male) were randomized to pravastatin 40 mg or matching placebo and to fosinopril 20mg or matching placebo. Using high resolution ultrasound, flow-mediated dilation (FMD) and nitroglycerin-induced dilation (NID) was assessed at baseline and after 4 years of treatment in a total of 276 subjects. At baseline, mean+/-standard error FMD was 4.73+/-0.49% and NID was 10.86+/-0.67%. Pravastatin significantly reduced total cholesterol and LDL cholesterol (p<0.01) and randomization to pravastatin was associated with a non-significant improvement of 18.9% in FMD (+0.80+/-0.95, p=0.09), without a significant change in NID. Interestingly, pravastatin significantly increased FMD by 34.9% in men (+1.23, p=0.04), but only 1.1% in women (+0.06, p=0.95). Fosinopril was not associated with a change in FMD or NID despite significantly decreasing urinary albumin excretion, systolic and diastolic blood pressure (all p<0.01). In conclusion, after 4 years of follow-up, pravastatin treatment tended to increase FMD and this effect was predominantly present in men. Fosinopril treatment did not modify FMD during long-term follow-up.

• Authors: Folkert W Asselbergs, Pim van der Harst, Arie M van Roon, Hans L Hillege, Paul E de Jong, Reinold O B Gans, Andries J Smit, Wiek H van Gilst
• Journal: Atherosclerosis (Atherosclerosis) Vol. 196 Issue 1 Pg. 349-355 (Jan 2008) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 17141245 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Pravastatin
• Fosinopril

Topics

• Adult
• Albuminuria (drug therapy)
• Angiotensin-Converting Enzyme Inhibitors (pharmacology)
• Brachial Artery (drug effects, physiopathology)
• Double-Blind Method
• Endothelium, Vascular (drug effects)
• Female
• Fosinopril (pharmacology)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (pharmacology)
• Longitudinal Studies
• Male
• Middle Aged
• Pravastatin (pharmacology)
• Vasodilation (drug effects)