IMPROVEMENT IN ARTERIAL STIFFNESS DURING HYPOLIPEMIC THERAPY IS OFFSET BY WEIGHT-GAIN

Fourteen patients with familial hypercholesterolaemia were managed wit h dietary advice and simvastatin for 12 months. Either nicotinic acid or cholestyramine resin was added to the regimen if serum cholesterol was not less than 5.5 mmol/l within 18 weeks. After dietary advice but before commencing pharmacotherapy for hyperlipidaemia, arterial stiff ness was measured in the common carotid and common femoral arteries. T hese studies were repeated after 12 months on pharmacotherapy. The pri mary objective of this study was to determine whether arterial stiffne ss could be altered with total cholesterol and low density lipoprotein (LDL) cholesterol lowering. Over the 12 month interval, serum total c holesterol, LDL cholesterol and triglycerides fell significantly, wher eas high density lipoprotein (HDL) cholesterol and body mass index (BM I) rose significantly. Mean supine blood pressure did not change signi ficantly. Arterial stiffness in the common carotid artery decreased fr om 1.04 +/- 0.21 x 10(5) N/m2 to 0.63 +/- 0.06 x 10(5) N/m2 (T= -2.67, P < 0.01) over the interval. Stiffness of the common femoral artery d ecreased from 2.10 +/- 0.57 x 10(5) N/m2 to 0.83 +/- 0.15 x 10(5) N/ms (T = -2.73, P < 0.01). The change in arterial stiffness was not direc tly related to changes in circulating lipids or supine blood pressure. Increase in BMI, however, correlated with change in arterial stiffnes s in the common femoral artery (R(s) = 0.53, P < 0.05) but not in the common carotid artery. An increase in BMI was associated with a smalle r decrease in common femoral arterial stiffness. Aggressive hypolipida emic therapy was therefore associated with a favourable effect on arte rial wall stiffness. However, in the common femoral artery this was of fset by weight gain.