Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial.

John, Michelle and Cockcroft, John R. and McKeever, Tricia M. and Coward, William R. and Shale, Dennis J. and Johnson, Simon R. and Thornton, Jim and Harrison, Timothy W. and Knox, Alan J. and Bolton, Charlotte E. (2015) Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial. International Journal of Chronic Obstructive Pulmonary Disease, 10 (1). pp. 211-221. ISSN 1178-2005

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Abstract

BACKGROUND:

There is excess cardiovascular mortality in patients with chronic obstructive pulmonary disease. Aortic stiffness, an independent predictor of cardiovascular risk, and systemic and airway inflammation are increased in patients with the disease. Statins modulate aortic stiffness and have anti-inflammatory properties. A proof-of-principle, double-blind, randomized trial determined if 6 weeks of simvastatin 20 mg once daily reduced aortic stiffness and systemic and airway inflammation in patients with chronic obstructive pulmonary disease.

METHODS:

Stable patients (n=70) were randomized to simvastatin (active) or placebo. Pre-treatment and post-treatment aortic stiffness, blood pressure, spirometry, and circulating and airway inflammatory mediators and lipids were measured. A predefined subgroup analysis was performed where baseline aortic pulse wave velocity (PWV) was >10 m/sec.

RESULTS:

Total cholesterol dropped in the active group. There was no significant change in aortic PWV between the active group and the placebo group (-0.7 m/sec, P=0.24). In those with aortic stiffness >10 m/sec (n=22), aortic PWV improved in the active group compared with the placebo group (-2.8 m/sec, P=0.03). Neither systemic nor airway inflammatory markers changed.

CONCLUSION:

There was a nonsignificant improvement in aortic PWV in those taking simvastatin 20 mg compared with placebo, but in those with higher baseline aortic stiffness (a higher risk group) a significant and clinically relevant reduction in PWV was shown.

Item Type: Article
Keywords: Chronic obstructive pulmonary disease, Arterial stiffness, Statins
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Child Health, Obstetrics and Gynaecology
University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Respiratory Medicine
Identification Number: https://doi.org/10.2147/COPD.S76061
Depositing User: Thornton, Jim
Date Deposited: 18 Feb 2016 10:36
Last Modified: 15 Sep 2016 20:25
URI: http://eprints.nottingham.ac.uk/id/eprint/31826

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