Endothelium-dependent Flow-mediated Vasodilation Research Articles

Docosahexaenoic Acid Supplementation, Vascular Function and Risk Factors for Cardiovascular Disease: A Randomized Controlled Trial in Young Adults

BackgroundA high consumption of omega‐3 long‐chain polyunsaturated fatty acids, and particularly docosahexaenoic acid (DHA), has been suggested to reduce the risk of cardiovascular disease (CVD). However, while DHA supplementation may have benefits for secondary prevention, few studies have investigated the role of DHA in the primary prevention of CVD. Here, we tested the hypothesis that DHA supplementation improves endothelial function and risk factors for CVD.Methods and ResultsHealthy volunteers (n=328), aged 18 to 37 years, were randomly assigned to 1.6 g DHA/day (from a microalgae source) together with 2.4 g/day carrier oil (index group) or to 4.0 g/day olive oil (control) (both given in eight 500‐mg capsules/day for 16 weeks). Flow‐mediated endothelium‐dependent vasodilation (FMD) of the brachial artery (primary outcome) was measured before and after the intervention (n=268) using high‐resolution vascular ultrasound. FMD was the same in both groups at randomization (mean, SD; 0.27, 0.1 mm), but postintervention was higher in the control group (0.29, 0.1 mm) compared with the DHA‐supplemented group (0.26, 0.1 mm; mean difference −0.03 mm; 95% CI −0.005 to −0.06 mm; P=0.02). Of other outcomes, only triglyceride (mean difference −28%, 95% CI −40% to −15%; P<0.0001) and very low‐density lipoprotein concentrations were significant lower in DHA‐supplemented individuals compared with controls.ConclusionsDHA supplementation did not improve endothelial function in healthy, young adults. Nevertheless, lower triglyceride concentrations with DHA supplementation was consistent with previous reports and could have benefits for the prevention of CVD.Clinical Trial Registration InformationURL: http://www.controlled-trials.com/ Unique identifier: ISRCTN no: 19987575.

Effect of blood pressure variability on endothelial function assessed by brachial artery flow mediated dilatation

Purpose: To examine the influence of blood pressure variability on endothelial function assessed by brachial artery flow mediated dilatation. Methods: We screened 190 individuals without history of cardiovascular disease in a primary prevention program recording age (45,62±8,72 years), sex (48,4% males), body mass index (BMI = 27,03±4,79 kg/m2), waist circumference (94,42±14,16 cm), total cholesterol (214,30±41,87 mg/dl), LDL-cholesterol (136,59±37,73 mg/dl), HDL-cholesterol (47,99±13,24 mg/dl), triglycerides (150,02±108,15 mg/dl), blood glucose (92,28±28,18 mg/dl), number of smoked cigarettes/day. We determined the brachial artery FMD according to the guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation. All subjects underwent a 24-hour Ambulatory Blood Pressure Monitoring (ABPM) on a working day, performing usual daily activities and avoiding heavy physical exercise. Blood pressure and heart rate readings were obtained every 15 minutes during daytime and every 30 minutes during nighttime. We recorded mean systolic and diastolic Blood Pressure (BP) and BP variability calculated as the Standard Deviation (SD) of mean blood pressure. After data collection we investigated the correlations (Pearson's r) between FMD values, classical risk factors and ABPM records, defining the magnitude of correlation as weak (r = 0,1 to 0,3), moderate (0,3 to 0,5) and high (0,5 to 1). Results: The uppermost observed correlations of brachial artery FMD values were in the moderate range, with systolic BP variability (r=-0,399, p<0,001), mean systolic BP (r=-0,372, p<0,001) and waist circumference (r=-0,360, p<0,001). We found weak significant correlations between FMD and mean diastolic BP (r=-0,288, p<0,001), age (r=-0,254, p<0,001), BMI (r=-0,290, p<0,001), number of smoked cigarettes/day (r=-0,223, p=002), HDL-cholesterol (r=0,168, p=0,021), triglycerides (r=-0,181, p=0,012) and blood glucose (r=-0,235, p=0,001). Moreover, the persons with endothelial dysfunction defined as a brachial artery FMD value less than 7,5% have significantly increased systolic blood pressure variability as compared with those with normal endothelial function (14,29±3,41 mmHg vs. 11,48±2,40 mmHg, p<0,001). Conclusions: Our study indicates that systolic blood pressure variability determined by ambulatory blood pressure monitoring is one of the most important factors that impacts on endothelial function.

Beyond Arterial Stenosis: Walking Disability in PAD Patients Is Related to Arterial Endothelial Function

METHODS: This was a prospective cohort study of PAD patients (N=100) presenting to a vascular surgery clinic. All patients received ABIs and brachial artery flow-mediated, endothelium-dependent, vasodilation (FMD) to assess arterial EF. PAD severity was assessed by the clinical Rutherford score. Demographic, biochemical and physiologic parameters were entered into regression equations to determine association with disease severity.

FRI0122 Long-term effects of etanercept and certolizumab pegol treatment on vascular function and lipid parameters in rheumatoid arthritis

BackgroundCardiovascular (CV) morbidity and mortality are increased in patients with rheumatoid arthritis (RA). Biologics may influence vascular function and lipids in RA, however, most studies have been short-term and less...

AB0551 Long-term effects of etanercept treatment on vascular function and lipid parameters in ankylosing spondylitis

BackgroundCardiovascular (CV) morbidity and mortality are increased in patients with arthritides, including ankylosing spondylitis (AS). Biologics may influence vascular function and lipids in AS, however a lot more information has...

THU0113 Predictive factors of response to rituximab therapy modify the accelerated atherosclerosis in patients with rheumatoid arthritis

BackgroundIncreased cardiovascular mortality has been associated with rheumatoid arthritis (RA). There are reports indicating that tumor necrosis factor blockers may exert favourable but transient effects on lipid profile, flow mediated...

AB0560 Evaluation of endothelial function in tocilizumab-treated rheumatoid arthritis patients refractory to TNF alfa inhibitors therapy

BackgroundCardiovascular disease is the major cause of excessive mortality in rheumatoid arthritis (RA). The endothelial dysfunction represents the earlier manifestation of Atherosclerosis and it predicts cardiovascular events.The effect of tumor...

AB0031 Lack of association between CXCL12 RS501120 polymorphism and cardiovascular disease in spanish patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is an autoimmune inflammatory disease associated with accelerated atherosclerosis [1]. Both a chronic inflammatory response [2]and genetic factors have been implicated in the augmented cardiovascular (CV) mortality...

Erectile dysfunction may be the first clinical sign of insulin resistance and endothelial dysfunction in young men

The purpose of this study is to investigate the possible underlying pathogenesis of erectile dysfunction (ED) without well-known etiology in young men under the age of 40 years. 192 patients and 33 normal controls were enrolled. ED was evaluated by using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Traditional cardiovascular risk factors, hormone levels, and vascular parameters were measured. Insulin resistance (IR) was measured by homeostasis model assessment (HOMA). Patients with ED had significantly higher levels of systolic blood pressure (SBP), high-sensitivity C-reactive protein (Hs-CRP), high Insulin resistance index (HOMA-IR) and carotid intima-media thickness (IMT), compared with controls. The brachial artery endothelium-dependent flow-mediated vasodilation (FMD) values were significantly lower in ED patients. By multivariate logistic regression analysis, FMD, SBP, Hs-CRP and HOMA-IR were significantly associated with ED. In receiver-operating characteristic (ROC) analysis, FMD was a significant predictor of ED (area under the curve (AUC) 0.933, p < 0.001). The cutoff value of FMD <10.4 % had sensitivity of 81.3 % and specificity of 100 %. HOMA-IR was also proven to be predictor of ED (AUC of HOMA-IR 0.759, p < 0.001). ED may be the first clinical sign of endothelial dysfunction and a clinical marker of cardiovascular and metabolic diseases. Subclinical endothelial dysfunction and insulin resistance may be the underlying pathogenesis of ED in young patients without well-known etiology. Measurement of FMD, HOMA-IR can improve our ability to predict and treat ED, as well as subclinical cardiovascular disease early in young men.

Abstract 251: Effects of n-3 Fatty Acids Supplementation on Endothelial Function and Inflammation in Peripheral Artery Disease: The OMEGA-PAD Trial

Background Patients with peripheral artery disease (PAD) have an increased risk for cardiovascular events, likely related to inflammation and impaired endothelial function. n-3 polyunsaturated fatty acids (n3-PUFAs) have been shown to improve endothelial function and reduce inflammation in other cohorts. We hypothesized that n3-PUFAs would improve endothelial function and the inflammatory profile in patients with PAD. Methods This is a randomized, double-blind, placebo-controlled trial: the OMEGA-PAD trial ( NCT01310270 ). Eighty patients aged 50 and more with intermitted claudication and an ankle-brachial index (ABI) of &lt;0.9 presenting to vascular surgery clinic at the Veterans Affairs Medical Center in San Francisco will be randomized to n3-PUFAs 2.2 g orally twice daily (total of 4.4gm/day) or a matched placebo for 1 month. Outcome measurements are done at baseline and after 1 month. The primary endpoint is a change in endothelial function measured by brachial artery flow mediated, endothelium-dependent vasodilation (FMD). Secondary endpoints include a change in inflammatory markers (C-reactive protein, IL-6, sICAM-1 and TNF-α), improvement in lipid profile (LDL, triglycerides, HDL), blood pressure and walking distance by questionnaire. The omega-3 index will be measured to ensure physiological treatment effect. Results Recruitment for the OMEGA-PAD trial started in April 2011. Fifty male veterans have been enrolled and randomized. The mean age is 67 ± 9 years. Mean index limb ABI is 0.8 ± 0.2. CAD is present in 36%, hypertension in 92%, and diabetes mellitus in 32%. 47% are current smokers and 45% are former smokers. Mean HgA1c is 8±1, LDL 93±37 mg/dL, triglycerides 160±98 mg/dL and HDL 43 ±12 mg/dL. Baseline brachial FMD is 7±4% indicating an overall impairment of endothelial function in this cohort. The inflammatory burden of this cohort is substantial as evidenced by hsCRP 5±5 mg/L. The baseline omega-3 index is 5±2%. Conclusions The OMEGA-PAD trial will test the novel hypothesis that n3-PUFAs supplementation improves functional and inflammatory parameters in a cohort at high vascular risk. The results of this study will provide valuable mechanistic insight into PUFAs as well as inform on this class of agents for cardiovascular outcome trials.

Acute effects of cigarette smoking in habitual smokers, a focus on endothelial function

Abstract Background The chronic effect of cigarette (cig.) smoking is well established. The acute effect of smoking abolishes the concept, argued by heavy smokers, to decrease the number of smoked cigarettes instead of quitting. Aim To detect the acute effects of cigarette smoking and the duration of these effects. Patients and methods Thirty four smokers (age 21–35 years) were studied at 3 occasions; 9 h after the last cig. smoking, 5 min after one cig. smoking and 30 min after 3 cig. smoking within 30 min. They were subjected to measurement of both ventricular functions using standard and tissue Doppler imaging (TDI), aortic distensibility, stiffness and endothelial function assessment by endothelium-dependent flow-mediated dilatation (FMD) and maximum vasodilatation. Results After one cigarette smoking, we found a statistically significant effect on blood pressure, Heart Rate, FMD percent, Dilation Ratio, aortic distensibility (P = 0.007), and aortic stiffness index (ASI) (P = 0.01). Furthermore the LV diastolic function was significantly impaired after smoking. Despite disappearance of acute effect of 3 cig. smoking within 30 min on blood pressure, Heart Rate and aortic distensibility, a significant difference was still found as regards FMD percent and dilation ratio denoting the extension of the endothelial dysfunction for more than 30 min after the last cigarette. Conclusion Many acute changes occur following one cigarette smoking even in habitual smokers. Persistence of endothelial dysfunction parameters after smoking indicates the failure of circulation adaptation in response to such offense that might contribute to the precipitation of acute events in vulnerable patients.

Effectiveness of Palmitoylethanolamide on Endothelial Dysfunction in Ocular Hypertensive Patients: A Randomized, Placebo-Controlled Cross-Over Study

We assessed the effect of palmitoylethanolamide (PEA) on systemic endothelial function in ocular hypertensive patients (OH). We enrolled in this randomized, double-blind, placebo-controlled, crossover single-center study 40 never-treated OH patients and 40 healthy age-matched controls. At baseline, each participant underwent endothelium-dependent flow-mediated vasodilation (FMD) measurement using a noninvasive high-resolution 2-dimensional ultrasonographic imaging of the brachial artery. OH patients were assigned randomly to receive either 300 mg PEA (Group A) or a matching placebo (Group B), twice a day for three months (T1). The first medication period was followed by a two-month washout period (T2), and then patients switched to PEA or placebo (depending on the first drug received) for another three months (T3). FMD evaluations were repeated at T1, T2, and T3. At baseline FMD values in OH patients and controls were 6.06 ± 0.60% vs. 10.85 ± 1.80%, respectively (P < 0.001). At T1, FMD and IOP of Group A were, respectively, 8.46 ± 1.09% vs. 6.08 ± 0.62% (P < 0.001, r = 0.96) and 22.18 ± 1.26 vs. 23.03 ± 0.88 mm Hg (P < 0.001). At T2, Group A had better FMD values than at baseline (6.59 ± 0.33% vs. 6.08 ± 0.62%, P < 0.05). At T3, subjects in Group B showed better FMD and IOP than at T2 (8.52 ± 1.07% vs. 6.05 ± 0.68%, P < 0.001, r = 0.97; and 22.43 ± 1.17 vs. 23.03 ± 0.83 mm Hg, P < 0.01, respectively). No side effects were observed. Three-month PEA intake reduced IOP and led to significantly improved FMD values in OH patients compared to placebo, by ameliorating peripheral endothelial function, and its positive effect lasted longer than the period of PEA consumption. No adverse events were recorded. (Controlled-trials.com number, ISRCTN72647928.).

Metformin reduces vascular endothelial dysfunction caused by an acute glucose load in patients with hypertension

Background. To investigate the effects of a single dose of metformin (MF) on endothelium-dependent vasodilatation and serum antioxidant and free fatty acid levels in patients with primary hypertension (PH) after an acute glucose load. Materials and methods. Patients with untreated PH were randomized to a no-metformin group (PH, n = 34) and a metformin group (PH+ MF, n = 28) who received a single dose of 500 mg metformin before testing. Healthy volunteers (n = 31) served as a control group. Brachial artery endothelium-dependent flow-mediated vasodilatation (FMD) was determined at 0, 1, 2 and 3 h after glucose load. Levels of serum superoxide dismutase (SOD), total antioxidant capacity (T-AOC), anti-superoxide anion free radical (AntiO2) and free fatty acids (FFA) were measured. Results. The FMD in the PH group decreased significantly 1 h after glucose load (PH: 10.9 ± 2.9% vs 13.67 ± 3.42% before glucose load). Metformin inhibited the effects of glucose load on FMD. At 1 h after acute glucose load, the concentrations of SOD, T-AOC and AntiO2 in the PH group decreased significantly compared with their fasting levels, and metformin inhibited the acute glucose load-induced decline in SOD and T-AOC levels. Conclusions. Metformin can prevent transient endothelial dysfunction caused by acute glucose load in patients with PH.

Carotid artery intima-media thickness and brachial artery flow-mediated vasodilatation in patients with rheumatoid arthritis

Cardiovascular (CV) morbidity and mortality are increased in patients with rheumatoid arthritis (RA). Our study aim was to determine the relationship between carotid artery intima-media wall thickness (IMT) and flow-mediated endothelium-dependent vasodilatation (FMD) in a patients with RA, in context with clinical and laboratory measurements. Fifty-two patients with RA and 30 matched healthy controls without clinically evident CV disease were studied. Brachial and carotid ultrasonography was performed to determine FMD and IMT, respectively. We also assayed immunological, inflammatory and metabolic laboratory markers. IMT was significantly higher in RA patients (1.00 ± 0.16 mm) patients than in controls (0.89 ± 0.13 mm) (P = 0.001). FMD was significantly lower in RA (9.16 ± 7.03) as compared to controls (12.60 ± 5.49) (p = 0.005). RA patients had significant positive correlations between erythrocyte sedimentation rate (ESR) (r=0.395 p = 0.021) and IMT and negative correlation between visual analog scale (VAS) (r= -0.311, p= 0.025) and IMT. RA patients who used low doses of corticosteroids have, statistically, significantly better FMD, than those who do not use corticosteroids. Linear regression analysis revealed that IMT was related to tender joint count (p = 0.008), VAS (p < 0.001), ESR (p = 0.048) and total cholesterol/high density lipoprotein cholesterol ratio (p = 0.039). In patients with RA, FMD was impaired and IMT was increased, indicating early endothelial dysfunction and accelerated atherosclerosis. Early treatment of disease may reduce the risk of atherosclerosis in RA.

Association Study of MIA3 rs17465637 Polymorphism with Cardiovascular Disease in Rheumatoid Arthritis Patients

Rheumatoid arthritis (RA) is a complex polygenic inflammatory disease associated with accelerated atherosclerosis. Melanoma inhibitor protein 3 (MIA3) is required for the export of collagen VlI (COL7A1) from the endoplasmic reticulum and it appears to be a tumor suppressor of malignant melanoma. Genome-wide association studies have described an association between MIA3 rs17465637 A/C polymorphisms and coronary artery disease and myocardial infarction. Because of that, we assessed the MIA3 rs17465637 polymorphism in 1505 RA Spanish patients stratified according to the presence/absence of cardiovascular (CV) disease. Also, a subgroup of patients without CV events was assessed for the presence of subclinical atherosclerosis using carotid ultrasound to establish carotid intima-media wall thickness and carotid plaques and brachial ultrasonography to determine the presence of endothelial dysfunction by flow-mediated endothelium-dependent and independent vasodilatation. MIA3 rs17465637 allele A showed a trend for association with the presence of carotid plaques (odds ratio 1.56, 95% confidence interval [0.96-2.51]; p=0.07). However, apart from an association of the MIA3 rs17465637 A allele with the risk of CV events in RA patients with dyslipidemia (p=0.018), no other significant associations were found between the presence of MIA3 rs17465637 A allele and the risk of suffering CV events or other surrogate markers of atherosclerosis. In conclusion, our results suggest a potential association of the MIA3 rs17465637 with CV disease in dyslipidemic patients with RA. However, additional studies are required to better establish the role of the MIA3 gene in mechanisms leading to the accelerated atherogenesis observed in RA.

Lack of association between the CXCL12 rs501120 polymorphism and cardiovascular disease in Spanish patients with rheumatoid arthritis

Rheumatoid arthritis (RA) is an inflammatory disease associated with accelerated atherosclerosis. CXCL12 is a strong chemotactic signal for lymphocytes. Because previous genome-wide association studies demonstrated an association between CXCL12 rs501120 and coronary artery disease, in the present study we assessed the potential association of this polymorphism with the risk of cardiovascular (CV) disease in 1,321 Spanish patients with RA. A subgroup of patients without CV events was also studied to determine the presence of subclinical atherosclerosis by ultrasonography (brachial flow-mediated endothelium-dependent vasodilatation and carotid intima-media wall thickness). However, no significant differences in genotypic and allelic frequencies between RA patients with and without CV events were observed, as was also the case when values of surrogate markers of atherosclerosis were assessed according to CXCL12 rs501120 genotype frequencies. In conclusion, our results do not confirm an association of the CXCL12 rs501120 polymorphism with atherosclerosis or with CV disease in RA.

The effect of enhanced external counterpulsation on C‐reactive protein and flow‐mediated dilation in porcine model of hypercholesterolaemia

Lipid disorder causes vascular endothelial cell damage and contributes to the early development of dyslipidaemia-induced atherosclerosis. In vivo and in vitro, it has been found that increasing shear stress can improve endothelial function. Clinically, enhanced external counterpulsation (EECP) plays important roles in the treatment of coronary artery disease by promoting arterial shear stress. The present study aims to evaluate the effect of EECP on vascular endothelial function in porcine hypercholesterolaemic model. Twenty-six hypercholesterolaemic pigs were equally divided into EECP group (HC-EECP group) and control group (HC group). Shear stress of a right forearm superficial artery was measured during EECP in comparison with the basal physiological status in the HC-EECP group. Endothelial-dependent flow-mediated vasodilation (FMD) was applied to assess endothelial function. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured at indicated time points. Endothelial shear stress was increased significantly during EECP treatment (P<0.001). Compared to HC group, hs-CRP decreased significantly by EECP at 18- and 36-h, respectively (P<0.05). FMD was improved significantly by EECP compared to that of HC group at 18 h (11.09 ± 5.63%) and at 36 h (11.42 ± 2.75%) post-EECP, P<0.05. Meanwhile, in animals of HC group, FMD was decreased from baseline 7.76 ± 3.70% to 6.75 ± 3.57% at 18 h and 5.07 ± 1.97% at 36 h, P<0.05. Long-term EECP can improve endothelial function partially by an increased endothelial shear stress in hypercholesterolaemic porcine model. This implies that long-term EECP can be used as a complementary therapeutic strategy to prevent atherosclerosis in hypercholesterolaemic patients.

Flow-Mediated Vasodilation Is Not Attenuated in Hypertensive Pregnancies Despite Biochemical Signs of Inflammation

Background. Our objective was to evaluate endothelial function and markers of inflammation during and after pregnancy in normal pregnancies compared to pregnancies complicated with hypertension or preeclampsia (PE). Methods and Results. We measured endothelium-dependent brachial artery flow-mediated vasodilation (FMD) and high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α) in 32 women with normal pregnancy and in 28 women whose pregnancy was complicated with hypertensive disorder in the second half of pregnancy and minimum 3-month postpartum. Enhancement of endothelial function was greater in hypertensive than normal pregnancies, the mean FMD% being 11.0% versus 8.8% during pregnancy (P = 0.194) and 8.0% versus 7.9% postpartum (P = 0.978). Concentrations of markers of inflammation were markedly increased in pregnant hypertensive group compared to those after delivery (hsCRP 4.5 versus 0.80 mg/L, P = 0.023, IL-6 2.1 versus 1.2 pg/mL, P = 0.006; TNF-α 1.9 versus 1.5 pg/mL, P = 0.030). There were no statistically significant associations between the markers of inflammation and FMD. Conclusions. Brachial artery FMD was not attenuated in the third trimester hypertensive pregnancies compared to normal pregnancies, whereas circulating concentrations of hsCRP and IL-6 and TNF-α reacted to hypertensive complications.

Anti-TNF-Alpha-Adalimumab Therapy Is Associated with Persistent Improvement of Endothelial Function without Progression of Carotid Intima-Media Wall Thickness in Patients with Rheumatoid Arthritis Refractory to Conventional Therapy

To determine whether treatment with the anti-TNF-alpha blocker adalimumab yields persistent improvement of endothelial function and prevents from morphological progression of subclinical atherosclerosis in patients with rheumatoid arthritis (RA) refractory to conventional therapy, a series of 34 consecutive RA patients, attending hospital outpatient clinics and who were switched from disease modifying antirheumatic drug therapy to anti-TNF-alpha-adalimumab treatment because of severe disease, were assessed by ultrasonography techniques before the onset of adalimumab therapy (at day 0) and then at day 14 and at month 12. Values of flow-mediated endothelium-dependent vasodilatation at day 14 and at month 12 were significantly higher (mean ± standard deviation (SD): 6.1 ± 3.9%; median: 5.7% at day 14, and mean ± SD: 7.4 ± 2.8%; median: 6.9% at month 12) than those obtained at day 0 (mean: 4.5 ± 4.0%; median: 3.6%; P = 0.03 and P < 0.001, resp.). Endothelium-independent vasodilatation results did not significantly change compared with those obtained at day 0. No significant differences were observed when carotid artery intima-media wall thickness values obtained at month 12 (mean ± SD: 0.69 ± 0.21 mm) were compared with those found at day 0 (0.65 ± 0.16 mm) (P = 0.3). In conclusion, anti-TNF-alpha-adalimumab therapy has beneficial effects on the development of the subclinical atherosclerosis disease in RA.

Mejoría del perfil de lípidos y la función endotelial con fenofibrato en pacientes con síndrome metabólico y nivel de C-LDL dentro del objetivo terapéutico

BackgroundsThe metabolic syndrome (MS), due to its elevated frequency and because it increases the risk of developing diabetes and having cardiovascular events, has become a public health problem in Mexico. One of its components is atherogenic dyslipidemia, which is made up of hypoalphalipoproteinemia-hypertriglyceridemia and C-LDL on variable, and even normal, levels. However, the international guides indicate C-LDL as the primary objective of the treatment, which means that the goal of correcting TG and C-HDL is frequently omitted in the clinical practice, this maintaining a residual risk in these patients. There is no official recommendation on the treatment of patients with hypertriglyceridemia-hypoalphalipoproteinemia or MS syndrome and C-LDL in the objective or studies on their vascular condition and response to treatment with a fibrate. ObjectiveTo determine the effect of fenofibrate on the lipid profile and the vascular status of patients with described MS and dyslipidemia. MethodA total of 12 patients were included in a prospective, longitudinal, crossed, double blind, placebo controlled study based on fenofibrate 160mg daily for 8 weeks. The serum lipid profile, endothelium-dependent flow-mediated vasodilatation function and carotid intima-media thickness as control and at the end of the treatment were evaluated. ResultsFenofibrate reduced significantly the TG levels, increased the C-HDL levels and improved the endothelial function in most of the patients. This was significantly associated to a decrease in the TG levels. ConclusionsThis is the first study to report these changes in this type of patient. This suggests that fenofibrate may be a therapeutic tool that corrects atherogenic dyslipidemia and reduces cardiovascular risk in this type of patient.