Abstract
ObjectiveIntensive as compared to mild statin therapy has been proven to be superior in improving cardiovascular outcome, whereas the effects of intensive statin therapy on inflammation and lipoprotein biomarkers are not well defined.MethodsThis study assigned essential hypertensive patients with dyslipidemia to 6 months administration of mild (1 mg/day, n = 34) or intensive pitavastatin therapy (4 mg/day, n = 29), and various lipid and inflammation biomarkers were measured at baseline, and 3 and 6 months after the start of treatment.ResultsBoth pitavastatin doses were well tolerated, and there were no serious treatment-related adverse events. After 6 months, significant improvements in total cholesterol, triglycerides, low-density lipoprotein (LDL-) cholesterol, LDL/high-density lipoprotein cholesterol (LDL/HDL), apolipoproteins B, C-II, and E, apolipoprotein-B/apolipoprotein-A-I (Apo B/Apo A-I), and malondialdehyde (MDA-) LDL were observed in both groups. Compared with the mild pitavastatin group, the intensive pitavastatin therapy showed significantly greater decreases in C reactive protein (F = 3.76, p<0.05), total cholesterol (F = 10.65), LDL-cholesterol (F = 23.37), LDL/HDL (F = 12.34), apolipoproteins B (F = 19.07) and E (F = 6.49), Apo B/Apo A-I (F = 13.26), and MDA-LDL (F = 5.76) (p<0.01, respectively).ConclusionIntensive pitavastatin therapy may have a more favorable effect not only in decreasing LDL-cholesterol but also in pleiotropic benefits in terms of improvement of apolipoproteins, inflammation, or oxidation.
Highlights
Hypertension and dyslipidemia, characterized by elevated triglycerides and low density lipoprotein (LDL-) cholesterol with low high density lipoprotein (HDL-) cholesterol, frequently coexist in the same individual [1,2,3]
Intensive as compared to mild statin therapy has been proven to be superior in improving cardiovascular outcome in clinical trials [12], whereas the relative benefits of such an intensive approach on inflammation, apolipoproteins, and oxidized lipoproteins have not been clarified
LDLcholesterol (p,0.01, respectively), and apolipoprotein B (p,0.05) were significantly higher in the pitavastatin 4 mg/day group than in the pitavastatin 1 mg/day group (Table 2). Both pitavastatin doses were well tolerated without adverse effects, and none of the serious adverse events was considered to be related to pitavastatin
Summary
Hypertension and dyslipidemia, characterized by elevated triglycerides and low density lipoprotein (LDL-) cholesterol with low high density lipoprotein (HDL-) cholesterol, frequently coexist in the same individual [1,2,3]. In addition to its effects on the lipid profile, pitavastatin has a number of pleiotropic benefits that reduce residual cardiovascular risk [8,9], and its beneficial effect in the regression of coronary atherosclerosis in patients with acute coronary syndrome has been reported [10,11]. Intensive as compared to mild statin therapy has been proven to be superior in improving cardiovascular outcome in clinical trials [12], whereas the relative benefits of such an intensive approach on inflammation, apolipoproteins, and oxidized lipoproteins have not been clarified. To validate the benefit of intensive lipid-lowering therapy with statins, the present study compared the effects of two different dosages of pitavastatin on inflammation and lipid profile parameters including apolipoproteins and oxidized lipoproteins in hypertensive patients with dyslipidemia
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