Doppler-ultrasound pilot study of the effects of long-term policosanol therapy on carotid-vertebral atherosclerosis

Abstract

This pilot study was conducted to document the beneficial lipid-lowering effect of policosanol on hemodynamic carotid-vertebral atherosclerosis (CVA) abnormalities. Twenty-two patients with mild CVA, including 12 patients with type II hyperlipidemia, were enrolled in this randomized, double-blind, Phase II, placebo-controlled trial. Eleven patients received 5 mg of oral policosanol twice daily, and 11 patients received placebo twice daily; all patients were treated for 1 year. Five functional Doppler-ultrasound flow parameters were measured on six arteries per patient and classified by using an objective response system. In the policosanol group, progression and stabilization of disease were absent, mixed response was lower, and regression was six times more frequent (6 of 11 patients); these findings were not statistically significant compared with the placebo group ( P = 0.06). The progression/regression (P:R) ratio in the policosanol group had a mean (0.5) two times lower than that in the control group (1.2) ( P = 0.03). The decrease in the P:R ratio was associated independently with a moderate percent reduction of the low-density lipoprotein cholesterol:high-density lipoprotein cholesterol ratio. Although the sample size and 1-year follow-up do not allow conclusions to be drawn, these results suggest that policosanol, in combination with a low-fat diet, improves hemodynamic abnormalities in patients with mild CVA and normal lipid levels or type II hyperlipidemia.