Effect of plasma cholesterol reduction by pravastatin on the functional properties of forearm arteries in hypercholesterolemic patients

D. Baldassarre, G. Busnach, M. Amato, F. Pazzucconi, C. R. Sirtori

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and Aim: Since functional properties in the vasculature of hypercholesterolemic subjects are impaired, a six-month pravastatin treatment (20 mg/die) was tested in an open design, on the impaired unstimulated forearm arterial compliance (Un-FAC(AUC)) of 14 asymptomatic type IIa familial hypercholesterolemic patients. In order to evaluate whether FAC(AUC) changes might be related to the extent of cholesterol reduction achieved, this evaluation was carried out in five severely hypercholesterolemic patients, undergoing LDL-apheresis. Methods and Results: Arterial functional properties, ie FAC(AUC) responses to glyceryl trinitrate (GTN-FAC(AUC)) and acetylcholine (ACh-FAC(AUC), four patients) and the effects on rest and peak forearm blood flow and vascular resistance were evaluated on the non-dominant arm using plethysmographic methods, that also allow the direct assessment of the non-linear "compliance-blood pressure" curve. Selective LDL-apheresis was performed by using a dextransulphate column. Pravastatin effectively lowered plasma total (-16%, p=0.002) and LDL cholesterol levels (-22%, p=0.006 vs baseline). Rest and peak flow, basal and post ischemic vascular resistance were not affected as well as Un-FAC(AUC) and GTN-FAC(AUC). However, in the four hypercholesterolemic patients undergoing ACh infusion, there was an improvement in the ACh-FAC(AUC) of borderline statistical significativity (p=0.056). LDL-apheresis reduced plasma total and LDL cholesterol levels by 55% and 59%, without affecting blood pressure. In this series of five patients Un-FAC(AUC) increased, the UnFAC(AUC) rise being inversely related to the absolute reduction of plasma total (r=0.92, p(AUC) and GTN-FAC(AUC). A possible selective improvement in the ACh-receptor-activated signal transduction pathway has been observed and the importance of a drastic reduction of cholesterol concentrations in order to affect the Un-FAC(AUC) is suggested.

Original languageEnglish
Pages (from-to)108-117
Number of pages10
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume9
Issue number3
Publication statusPublished - Jun 1999

Fingerprint

Pravastatin
Forearm
arteries
functional properties
Arteries
Cholesterol
cholesterol
Blood Component Removal
low density lipoprotein cholesterol
blood vessels
Vascular Resistance
compliance
LDL Cholesterol
Compliance
blood pressure
Blood Pressure
cholinergic receptors
Nitroglycerin
Cholinergic Receptors
acetylcholine

Keywords

  • Arterial compliance
  • Hypercholesterolemia
  • LDL-apheresis
  • Plethysmography
  • Pravastatin

ASJC Scopus subject areas

  • Food Science
  • Medicine (miscellaneous)
  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Effect of plasma cholesterol reduction by pravastatin on the functional properties of forearm arteries in hypercholesterolemic patients. / Baldassarre, D.; Busnach, G.; Amato, M.; Pazzucconi, F.; Sirtori, C. R.

In: Nutrition, Metabolism and Cardiovascular Diseases, Vol. 9, No. 3, 06.1999, p. 108-117.

Research output: Contribution to journalArticle

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AU - Baldassarre, D.

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AU - Amato, M.

AU - Pazzucconi, F.

AU - Sirtori, C. R.

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N2 - Background and Aim: Since functional properties in the vasculature of hypercholesterolemic subjects are impaired, a six-month pravastatin treatment (20 mg/die) was tested in an open design, on the impaired unstimulated forearm arterial compliance (Un-FAC(AUC)) of 14 asymptomatic type IIa familial hypercholesterolemic patients. In order to evaluate whether FAC(AUC) changes might be related to the extent of cholesterol reduction achieved, this evaluation was carried out in five severely hypercholesterolemic patients, undergoing LDL-apheresis. Methods and Results: Arterial functional properties, ie FAC(AUC) responses to glyceryl trinitrate (GTN-FAC(AUC)) and acetylcholine (ACh-FAC(AUC), four patients) and the effects on rest and peak forearm blood flow and vascular resistance were evaluated on the non-dominant arm using plethysmographic methods, that also allow the direct assessment of the non-linear "compliance-blood pressure" curve. Selective LDL-apheresis was performed by using a dextransulphate column. Pravastatin effectively lowered plasma total (-16%, p=0.002) and LDL cholesterol levels (-22%, p=0.006 vs baseline). Rest and peak flow, basal and post ischemic vascular resistance were not affected as well as Un-FAC(AUC) and GTN-FAC(AUC). However, in the four hypercholesterolemic patients undergoing ACh infusion, there was an improvement in the ACh-FAC(AUC) of borderline statistical significativity (p=0.056). LDL-apheresis reduced plasma total and LDL cholesterol levels by 55% and 59%, without affecting blood pressure. In this series of five patients Un-FAC(AUC) increased, the UnFAC(AUC) rise being inversely related to the absolute reduction of plasma total (r=0.92, p(AUC) and GTN-FAC(AUC). A possible selective improvement in the ACh-receptor-activated signal transduction pathway has been observed and the importance of a drastic reduction of cholesterol concentrations in order to affect the Un-FAC(AUC) is suggested.

AB - Background and Aim: Since functional properties in the vasculature of hypercholesterolemic subjects are impaired, a six-month pravastatin treatment (20 mg/die) was tested in an open design, on the impaired unstimulated forearm arterial compliance (Un-FAC(AUC)) of 14 asymptomatic type IIa familial hypercholesterolemic patients. In order to evaluate whether FAC(AUC) changes might be related to the extent of cholesterol reduction achieved, this evaluation was carried out in five severely hypercholesterolemic patients, undergoing LDL-apheresis. Methods and Results: Arterial functional properties, ie FAC(AUC) responses to glyceryl trinitrate (GTN-FAC(AUC)) and acetylcholine (ACh-FAC(AUC), four patients) and the effects on rest and peak forearm blood flow and vascular resistance were evaluated on the non-dominant arm using plethysmographic methods, that also allow the direct assessment of the non-linear "compliance-blood pressure" curve. Selective LDL-apheresis was performed by using a dextransulphate column. Pravastatin effectively lowered plasma total (-16%, p=0.002) and LDL cholesterol levels (-22%, p=0.006 vs baseline). Rest and peak flow, basal and post ischemic vascular resistance were not affected as well as Un-FAC(AUC) and GTN-FAC(AUC). However, in the four hypercholesterolemic patients undergoing ACh infusion, there was an improvement in the ACh-FAC(AUC) of borderline statistical significativity (p=0.056). LDL-apheresis reduced plasma total and LDL cholesterol levels by 55% and 59%, without affecting blood pressure. In this series of five patients Un-FAC(AUC) increased, the UnFAC(AUC) rise being inversely related to the absolute reduction of plasma total (r=0.92, p(AUC) and GTN-FAC(AUC). A possible selective improvement in the ACh-receptor-activated signal transduction pathway has been observed and the importance of a drastic reduction of cholesterol concentrations in order to affect the Un-FAC(AUC) is suggested.

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