Abstract 14163: Pravastatin Combined with Valsartan Shows Additive Beneficial Vascular Effects in Patients with Hypercholesterolemia
Background: Biological mechanisms underlying statin and angiotensin II type 1 receptor blocker therapies differ. Therefore, we compared blood pressure and vascular responses with inflammatory biomarkers to these therapies either alone or in combination in hypercholesterolemic patients.
Methods: This was a randomized, single-blind, placebo-controlled cross-over trial with three treatment arms (each 2 months) and two washout periods (each 2 months). Forty-nine hypercholesterolemic patients were given pravastatin 40 mg and placebo, pravastatin 40 mg and valsartan 160 mg, or valsartan 160 mg and placebo daily during each 2 month treatment period.
Results: When compared with pravastatin alone, valsartan alone or combined therapy significantly changed blood pressure (P<0.05 by repeated measures ANOVA). When compared with valsartan alone, pravastatin alone or combined therapy significantly changed lipoproteins levels (P<0.001 by repeated measures ANOVA).All three treatment arms significantly improved flow-mediated dilator response to hyperemia (FMD) relative to baseline measurements. However, FMD were changed to a greater extent with combined therapy when compared with pravastatin or valsartan alone (P<0.001 by repeated measures ANOVA). Relative to baseline measurements, valsartan alone, pravastatin alone or combined therapy reduced hs-CRP levels (P=0.109, P<0.001, and P<0.001 by Wilcoxon Signed Rank test, respectively). Interestingly, when compared with valsartan or pravastatin alone, combined therapy significantly reduced hs-CRP levels to a greater extent (P=0.011 by repeated measures ANOVA on Ranks). All three treatment arms significantly increased plasma adiponectin levels relative to baseline measurements. However, combined therapy significantly increased plasma adiponectin levels to a greater extent than monotherapy (P=0.004 by repeated measures ANOVA on Ranks).
Conclusions: Pravastatin combined with valsartan improves endothelial function with improving inflammatory biomarkers to a greater extent than monotherapy with either drug in hypercholesterolemic patients.
- © 2012 by American Heart Association, Inc.