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The effect of cholesterol lowering on carotid and femoral artery wall stiffness and thickness in patients with familial hypercholesterolaemia
Author(s) -
TJ Smilde,
Franchette W P J van den Berkmortel,
Hub Wollersheim,
H. van Langen,
J.J.P. Kastelein,
A.F.H. Stalenhoef
Publication year - 2000
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.2000.00654.x
Subject(s) - medicine , simvastatin , intima media thickness , cardiology , cholesterol , common carotid artery , atorvastatin , artery , cholesterol lowering , femoral artery , right common carotid artery , ultrasound , familial hypercholesterolemia , endocrinology , carotid arteries , radiology
Background Early in the process of atherosclerosis, changes in vessel wall stiffness and thickness may occur. The present study evaluates the effect of cholesterol reduction on artery wall stiffness and intima media thickness in patients with familial hypercholesterolaemia (FH). Materials and methods Forty‐five patients with familial hypercholesterolaemia (mean age 46 ± 10 years) with untreated LDL cholesterol concentration > 9 mmol L −1 , were studied before and after one year of cholesterol lowering therapy with statins (simvastatin, atorvastatin 40–80 mg day −1 ). The distensibility (DC in 10 −3 kPa −1 ) and compliance (CC in mm 2 . kPa −1 ) of the common carotid artery (CCA) (right and left side) and common femoral artery (CFA) (right side) were determined by a wall track system (Pie Medical). The intima media thickness (IMT) (both right and left) of the CCA, bulb (BUL), internal carotid artery (ICA) and CFA were measured in mm by high‐resolution ultrasound (Biosound). Results The mean concentration of total cholesterol (TC), LDL‐cholesterol (LDL‐C) and triglycerides (TG) were reduced significantly by 43%, 51% and 25%, respectively, whereas HDL‐cholesterol (HDL‐C) increased by 13% ( P < 0.001). In the CFA, the DC and CC increased significantly (DC from 7.9 ± 3.0 to 9.1 ± 3.7 in 10 −3 kPa −1 ; CC 0.5 ± 0.2–0.6 ± 0.3 in mm 2 . kPa −1 ), whereas the DC and CC did not change in the CCA. In contrast, the IMT of the CCA decreased significantly in both men and women whereas an IMT decrease was also seen in the BUL and ICA in premenopausal women. A LDL‐cholesterol reduction of 44.8% and 45.4% was necessary to induce significant decreases in IMT and increases in DC and CC. Conclusions One year of cholesterol lowering therapy in FH decreases the wall stiffness in the CFA and the arterial wall thickness in the CCA.