HEMODYNAMIC-CHANGES ASSOCIATED WITH REDUCTION IN TOTAL CHOLESTEROL BYTREATMENT WITH THE HMG-COA REDUCTASE INHIBITOR PRAVASTATIN

Hemodynamic changes associated with the lowering of total cholesterol (TC) by the water-soluble HMG-COA reductase inhibitor pravastatin were investigated in 59 patients with hypercholesterolemia (TC level at le ast 220 mg/dl) who received pravastatin therapy for 6 months. The pati ents were divided into two groups according to the reduction in TC: a greater than or equal to 15% reduction group and a < 15% reduction gro up. The changes in hemodynamics were compared before and after pravast atin treatment. No changes in blood pressure, heart rate or aortic dam ping factor were found in either group. However, significant decreases in pulse wave velocity and total peripheral resistance, and increase in cardiac output were seen in the greater than or equal to 15% reduct ion group. All these hemodynamic parameters remained unchanged in the < 15% reduction group. The 12 patients with a clear pravastatin-induce d reduction in TC maintained over a 5-year period showed no changes in blood pressure, heart rate or aortic damping factor, but the reductio ns in pulse wave velocity and total peripheral resistance, and increas e in cardiac output were maintained. These changes in hemodynamics wer e not dependent on aortic elasticity, and appeared to result from impr oved peripheral hemodynamics. Lowering of TC levels by pravastatin res ults in improvement in the peripheral endothelium-dependent vasodilati on disorder associated with hypercholesterolemia. (C) 1997 Elsevier Sc ience Ireland Ltd.