PP.12.26] METABOLIC EFFECTS OF DIFFERENT LIPID-LOWERING THERAPY REGIMENS IN HYPERTENSIVE PATIENTS WITH HIGH CARDIOVASCULAR RISK

Abstract

Objective: Aim: This open randomized study compares effects of 6 months-long treatment with rosuvastatin (5–20 mg/day) and with combination of atorvastatin (10–20 mg/day) and ezetimibe (10 mg/day) on plasma levels of lipids, adipocytokines and parameters of carbohydrate metabolism in hypertensive pts with high cardiovascular risk. Design and method: Methods: A total of 31 hypertensive pts with coronary artery disease or type 2 diabetes mellitus recruited in the study were randomized into two groups: pts receiving rosuvastatin therapy (Gr.1, n = 16) and pts receiving combination of atorvastatin and ezetimibe (Gr.2, n = 15). Plasma levels of glucose, insulin, leptin, and adiponectin were evaluated; HOMA-IR index was calculated. Results: Average doses after 6 months of therapy of rosuvastatin and of atorvastatin were 12.5 mg/day and 13.3 mg/day, respectively. Reduction of LDL-C levels was 51.7 in Gr.1 and 51.8% in Gr.2. The increases in basal glycemia, basal insulinemia, HbA1c levels (from 6.47% [6.10–7.02%] to 6.98% [6.23–8.18%]), and HOMA-IR were found only in Gr.2 (p < 0.05 for all). Changes of leptin levels were diverse: 73% pts of Gr.1 demonstrated decrease of leptin levels, whereas 67% of pts in Gr.2 showed 57%-increase of leptin concentrations. Degree of increased basal glycemia was associated with increase of leptin levels in Gr.2 (Rs = 0.37, p = 0.034). Conclusions: In case of equivalent degree of the decrease in LDL-C levels, therapy with combination of atorvastatin and ezetimibe, unlike rosuvastatin treatment, induced increases in basal glycemia, insulinemia, HbA1c, and HOMA-IR index. Our data suggest that leptin is involved in the mechanisms of adverse metabolic effects of the combination of atorvastatin and ezetimibe.