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Sustained Improvement of Arterial Stiffness and Blood Pressure after Long-Term Rosuvastatin Treatment in Patients with Inflammatory Joint Diseases: Results from the RORA-AS Study.

Ikdahl E, Rollefstad S, Hisdal J, Olsen IC, Pedersen TR, Kvien TK, Semb AG - PLoS ONE (2016)

Bottom Line: AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end.We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD.These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins.

View Article: PubMed Central - PubMed

Affiliation: Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.

ABSTRACT

Objective: Patients with inflammatory joint diseases (IJD) have a high prevalence of hypertension and increased arterial stiffness. The aim of the present study was to evaluate the effect of long-term rosuvastatin treatment on arterial stiffness, measured by augmentation index (AIx) and aortic pulse wave velocity (aPWV), and blood pressure (BP) in IJD patients with established atherosclerosis.

Methods: Eighty-nine statin naïve IJD patients with carotid atherosclerotic plaque(s) (rheumatoid arthritis n = 55, ankylosing spondylitis n = 23, psoriatic arthritis n = 11) received rosuvastatin for 18 months to achieve low-density lipoprotein cholesterol goal ≤1.8 mmol/L. Change in AIx (ΔAIx), aPWV (ΔaPWV), systolic BP (ΔsBP) and diastolic BP (ΔdBP) from baseline to study end was assessed by paired samples t-tests. Linear regression was applied to evaluate associations between cardiovascular disease (CVD) risk factors, rheumatic disease specific variables and medication, and ΔAIx, ΔaPWV, ΔsBP and ΔdBP.

Results: AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end. The mean (95%CI) changes were: ΔAIx: -0.34 (-0.03, -0.65)% (p = 0.03), ΔaPWV: -1.69 (-0.21, -3.17) m/s2 (p = 0.03), ΔsBP: -5.27 (-1.61, -8.93) mmHg (p = 0.004) and ΔdBP -2.93 (-0.86, -5.00) mmHg (p = 0.01). In linear regression models, ∆aPWV was significantly correlated with ΔsBP and ΔdBP (for all: p<0.001).

Conclusions: There is an unmet need of studies evaluating CVD prevention in IJD patients. We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD. These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins.

Trial registration: ClinicalTrials.gov NCT01389388.

No MeSH data available.


Related in: MedlinePlus

Flow chart of the ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) study.Of the 138 patients who were initially included in the study, 24 patients withdrew. Ninety-six patients completed 18 months of treatment with rosuvastatin. Adequate quality of AIx/aPWV measurements was obtained in 89 patients who were included in the analyses.
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pone.0153440.g001: Flow chart of the ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) study.Of the 138 patients who were initially included in the study, 24 patients withdrew. Ninety-six patients completed 18 months of treatment with rosuvastatin. Adequate quality of AIx/aPWV measurements was obtained in 89 patients who were included in the analyses.

Mentions: A flow chart of the RORA-AS study is shown in Fig 1. Patients with AS, RA and PsA were well matched concerning baseline characteristics, except physical activity (p = 0.002) and for the expected gender differences (p = 0.01), use of prednisolone (p = 0.02) and synthetic disease modifying anti-rheumatic drugs (sDMARDs) (p = 0.01) (Table 1). Antihypertensive medication was either initiated or changed during the study period in 18 patients, and these patients were excluded from further statistical analyses related to sBP and dBP. The mean rosuvastatin dose given at 18 months was 30 mg o.d.


Sustained Improvement of Arterial Stiffness and Blood Pressure after Long-Term Rosuvastatin Treatment in Patients with Inflammatory Joint Diseases: Results from the RORA-AS Study.

Ikdahl E, Rollefstad S, Hisdal J, Olsen IC, Pedersen TR, Kvien TK, Semb AG - PLoS ONE (2016)

Flow chart of the ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) study.Of the 138 patients who were initially included in the study, 24 patients withdrew. Ninety-six patients completed 18 months of treatment with rosuvastatin. Adequate quality of AIx/aPWV measurements was obtained in 89 patients who were included in the analyses.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836743&req=5

pone.0153440.g001: Flow chart of the ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) study.Of the 138 patients who were initially included in the study, 24 patients withdrew. Ninety-six patients completed 18 months of treatment with rosuvastatin. Adequate quality of AIx/aPWV measurements was obtained in 89 patients who were included in the analyses.
Mentions: A flow chart of the RORA-AS study is shown in Fig 1. Patients with AS, RA and PsA were well matched concerning baseline characteristics, except physical activity (p = 0.002) and for the expected gender differences (p = 0.01), use of prednisolone (p = 0.02) and synthetic disease modifying anti-rheumatic drugs (sDMARDs) (p = 0.01) (Table 1). Antihypertensive medication was either initiated or changed during the study period in 18 patients, and these patients were excluded from further statistical analyses related to sBP and dBP. The mean rosuvastatin dose given at 18 months was 30 mg o.d.

Bottom Line: AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end.We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD.These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins.

View Article: PubMed Central - PubMed

Affiliation: Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.

ABSTRACT

Objective: Patients with inflammatory joint diseases (IJD) have a high prevalence of hypertension and increased arterial stiffness. The aim of the present study was to evaluate the effect of long-term rosuvastatin treatment on arterial stiffness, measured by augmentation index (AIx) and aortic pulse wave velocity (aPWV), and blood pressure (BP) in IJD patients with established atherosclerosis.

Methods: Eighty-nine statin naïve IJD patients with carotid atherosclerotic plaque(s) (rheumatoid arthritis n = 55, ankylosing spondylitis n = 23, psoriatic arthritis n = 11) received rosuvastatin for 18 months to achieve low-density lipoprotein cholesterol goal ≤1.8 mmol/L. Change in AIx (ΔAIx), aPWV (ΔaPWV), systolic BP (ΔsBP) and diastolic BP (ΔdBP) from baseline to study end was assessed by paired samples t-tests. Linear regression was applied to evaluate associations between cardiovascular disease (CVD) risk factors, rheumatic disease specific variables and medication, and ΔAIx, ΔaPWV, ΔsBP and ΔdBP.

Results: AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end. The mean (95%CI) changes were: ΔAIx: -0.34 (-0.03, -0.65)% (p = 0.03), ΔaPWV: -1.69 (-0.21, -3.17) m/s2 (p = 0.03), ΔsBP: -5.27 (-1.61, -8.93) mmHg (p = 0.004) and ΔdBP -2.93 (-0.86, -5.00) mmHg (p = 0.01). In linear regression models, ∆aPWV was significantly correlated with ΔsBP and ΔdBP (for all: p<0.001).

Conclusions: There is an unmet need of studies evaluating CVD prevention in IJD patients. We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD. These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins.

Trial registration: ClinicalTrials.gov NCT01389388.

No MeSH data available.


Related in: MedlinePlus