Abstract
Background: Statin therapy may alter arterial stiffness by decreasing the low density lipoprotein cholesterol (LDL-C) content within blood vessel walls and reducing inflammation. Progression of arterial stiffness with prolonged statin treatment is not clear. Methods: The subset of MESA participants (n=1,225) with comprehensive data on statin use who underwent B-mode carotid ultrasound at baseline (visit 1) and after (mean ± SD) 9.3±0.7 years (visit 5) was analyzed. Arterial stiffness was measured using carotid distensibility coefficient (DC) and Young’s elastic modulus (YEM) at MESA exam 1 and 5. Linear regression models evaluated associations of ten-year change in DC and YEM with statin treatment duration and intensity during visits 1-4. Models were adjusted for age, sex, ethnicity, systolic blood pressure (SBP), diabetes status, alcohol use, smoking, and lipid profiles. Results: At baseline, participants were 66.5±8.1 years of age, 41% female, 36% Caucasian, 30% African American, 13.7% Asian American, and 20.0% Hispanic, with LDL-C of 149.5±14.5 mg/dL; DC was 2.88×10-3±1.28×10-3 mmHg-1, YEM was 1659±1056 mmHg. Participants not on statin therapy at any visit had greater baseline arterial stiffness measures compared to participants who were treated at all visits (YEM: 1,724 ±993 mmHg vs 1,457 ±776 mmHg; p=0.0003; DC: 2.72 ±1.22×10-3 mmHg-1 vs 3.22 ±1.33×10-3 mmHg-1; p<0.0001). In unadjusted models, neither duration nor intensity of statin therapy was associated with changes in arterial stiffness measures over 10 years. Fully adjusted multivariable linear regression models showed associations with age and SBP but demonstrated no significant associations between DC and YEM and treatment duration or any statin intensity (table). Conclusions: Statin therapy was not associated with progression of carotid artery distensibility and elasticity over nearly a decade of follow up regardless of treatment duration or dose intensity.
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