Circulation. 2003;108:1481-1486
Published online before print September 2, 2003, doi: 10.1161/01.CIR.0000090686.57897.F5
Published online before print September 2, 2003, doi: 10.1161/01.CIR.0000090686.57897.F5
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(Circulation. 2003;108:1481.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Cholesterol Reduction With Atorvastatin Improves Walking Distance in Patients With Peripheral Arterial Disease
From the Cardiovascular Division (E.R.M.), University of Pennsylvania School of Medicine, Philadelphia, Pa; Section of Vascular Medicine (W.R.H.), University of Colorado School of Medicine, Denver, Colo; and Cardiovascular Division (M.A.C.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.
Correspondence to Mark A. Creager, MD, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. E-mail mcreager{at}partners.org
Received February 4, 2003; de novo received May 7, 2003; revision received July 7, 2003; accepted July 8, 2003.
Background— Cholesterol modification reduces cardiovascular events in patients with atherosclerosis, including those with peripheral arterial disease. The purpose of this study was to determine whether cholesterol lowering with atorvastatin improves walking performance in patients with intermittent claudication.
Methods and Results— This randomized, double-blind, parallel-design study included 354 persons with claudication attributable to peripheral arterial disease. Patients were treated with placebo, atorvastatin (10 mg per day), or atorvastatin (80 mg per day) for 12 months. The outcome measures included change in treadmill exercise time and patient-reported measures of physical activity and quality of life based on questionnaires. Maximal walking time after 12 months of treatment with atorvastatin did not change significantly. However, there was improvement in pain-free walking time after 12 months of treatment for the 80-mg (P=0.025) group compared with placebo. A physical activity questionnaire demonstrated improvement in ambulatory ability for the 10- and 80-mg groups (P=0.011), whereas 2 quality of life instruments, the Walking Impairment Questionnaire and Short Form 36 Questionnaire, did not show significant change.
Conclusions— Atorvastatin improves pain-free walking distance and community-based physical activity in patients with intermittent claudication. When treated with atorvastatin, patients with peripheral arterial disease may experience improvement in symptoms to complement the anticipated reduction in cardiovascular events reported in other studies of statins.
Key Words: claudication • lipids • peripheral vascular disease • statins • hypercholesterolemia
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