Simvastatin improves arterial compliance in the lower limb but not in the aorta

Several cardiovascular risk factors adversely affect arterial compliance or the distensibility of large arteries. The role of raised low-density lipop roteins (LDL) cholesterol is uncertain, most studies having shown little ef fect. We, therefore, investigated whether lowering LDL would improve arteri al compliance. Twenty hypercholesterolemic subjects (LDL cholesterol 4.95 /- 1.11 mmol/l) were randomized to simvastatin (20 or 40 mg daily) or place bo, each for 4 weeks. Arterial function was assessed at the end of the plac ebo and simvastatin periods, systemic arterial compliance (SAC) and pulse w ave velocities (PWV) centrally (aorto-femoral) and peripherally (femoral-po sterior tibial). Results: Lipoproteins (LDL) cholesterol was reduced simila rly with 20 and 40 mg simvastatin (ten subjects each dose) and data were po oled. Lipoproteins (LDL) cholesterol fell 39%, plasma triglyceride fell 18% and high-density lipoprotein (HDL) cholesterol rose 12%, all significant. Systemic arterial compliance (SAC) and central PWV did not change significa ntly but peripheral PWV showed evidence of greater compliance after simvast atin (10.1 +/- 1.3 vs. 9.4 +/- 1.3 m/s with placebo and simvastatin, P < 0. 03), distensibility being inversely related to PWV. Improvement in PWV was greatest in those with poorest baseline values, r = 0.50; P < 0.02. Conclus ion: Peripheral PWV was alone improved with LDL lowering probably because o f the muscularity of that arterial bed; central PWV and SAC (in the elastic aorta) were not influenced. (C) 2001 Elsevier Science Ireland Ltd. All rig hts reserved.