Effects of atorvastatin and vitamin C on endothelial function of hypercholesterolemic patients

We tested the effects of vitamin C and atorvastatin treatment on endotheliu m-dependent and endothelium-independent vasodilation in 18 hypercholesterol emic patients (ten men and eight women, aged 20-46 years) in comparison wit h 12 normal volunteers (seven men and five women, aged 20-45 years). The re sponses of the forearm blood flow (FBF) to acetylcholine (ACh) (7.5, 15 and 30 mu g/min), sodium nitroprusside (SNP) (0.8, 1.6, 3.2 mu g/min) and L-NM MA (2, 4, 8 mu mol/min) were evaluated at baseline and after 1 month of ato rvastatin (10 mg/day) treatment. Drugs were infused into the brachial arter y and FBF was measured by strain-gauge plethysmography. At baseline, the re sponse to ACh was significantly attenuated in hypercholesterolemics versus controls: at the highest dose (30 mu g/min), FBF was 27.0 +/- 3.4 versus 11 .5 +/- 1.9 ml.100 ml tissue(-1).min(-1) respectively (P < 0.0001). No signi ficant differences were found between groups during SNP infusion. The atorv astatin treatment significantly improved ACh-stimulated FBF: at highest dos e the FBF increased to 14.9+/-1.5 ml.100 ml tissue(-1).min(-1) (P < 0.0001) . Similarly, the L-NMMA endothelial effects were significantly enhanced by lipid-lowering treatment, supporting the improvement of basal nitric oxide. Vitamin C increased ACh-vasodilation in the same way before and after ator vastatin treatment. In conclusion, the endothelial dysfunction in hyperchol esterolemics is due to an oxidative stress and atorvastatin rapidly improve s both basal and stimulated endothelium-dependent vasodilation. (C) 2000 El sevier Science Ireland Ltd. All rights reserved.