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

Author(s): Asselbergs FW, van der Harst P, van Roon AM, Hillege HL, de Jong PE, Gans RO, Smit AJ, van Gilst WH

Affiliation(s): Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. fwasselbergs@hotmail.com

Publication date & source: 2008-01, Atherosclerosis., 196(1):349-55. Epub 2006 Dec 1.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

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.

Page last updated: 2008-03-26

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