The purpose of this double-blind, randomized, placebo-controlled trial was to determine the long-term effects of pravastatin and fosinopril treatment on peripheral endothelial function in subjects with albuminuria. Subjects (mean age 51 years, 63% male) were randomized to pravastatin 40 mg or matching placebo and to fosinopril 20 mg or matching placebo. Using high resolution ultrasound, flow-mediated dilation (FMD) and nitroglycerin-induced dilation (NID) was assessed at baseline and after 4 years of treatment in a total of 276 subjects. At baseline, mean +/- standard error FMD was 4.73 +/- 0.49% and NID was 10.86 +/- 0.67%. Pravastatin significantly reduced total cholesterol and LDL cholesterol (p <0.01) and randomization to pravastatin was associated with a non-significant improvement of 18.9% in FMD (+0.80 +/- 0.95, p = 0.09), without a significant change in NID. Interestingly, pravastatin significantly increased FMD by 34.9% in men (+1.23, p = 0.04), but only 1.1 % in women (+0.06, p = 0.95). Fosinopril was not associated with a change in FMD or NID despite significantly decreasing urinary albumin excretion, systolic and diastolic blood pressure (all p <0.01). In conclusion, after 4 years Of follow-up, pravastatin treatment tended to increase FMD, and this effect was predominantly present in men. Fosinopril treatment did not modify FMD during long-term follow-up. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
|Nummer van het tijdschrift||1|
|Status||Published - jan-2008|