Korean Circ J.  2003 Nov;33(11):1053-1059. 10.4070/kcj.2003.33.11.1053.

Effects of Simvastatin Alone or Combined With Ramipril on Nitric Oxide Bioactivity and Inflammation Markers in Hypercholesterolemic Patients

• Son JW
• Koh KK
• You SM
• Ryu WS
• Ahn JY
• Kim HG
• Kim DS
• Kim HS
• Oh KJ
• Shin EK

• KMID: 2145617
• DOI: http://doi.org/10.4070/kcj.2003.33.11.1053

Abstract

BACKGROUND AND OBJECTIVES
Because the mechanisms of the biological effects of statin and antiotensin converting enzyme inhibitor therapies differ, the vascular responses to these therapies were studied in hypercholesterolemic patients.
MATERIALS AND METHODS
Simvastatin, 20 mg, placebo or ramipril, 10 mg, were administered daily for 2 months, with a 2 month washout, to 32 hypercholesterolemic patients. This was a randomized, double-blind, placebo-controlled, crossover in design study.
RESULTS
Simvastatin alone, or in combination with ramipril, significantly changed the lipoproteins, and improved the percentage of the flow-mediated dilator response to hyperemia by 46+/-48% and by 59+/-66%, respectively, relative to the baseline measurements (both p<0.001). The plasma malondialdehyde levels were reduced, relative to baseline measurements, by 6+/-57% (p=0.045) and 13+/-47% (p=0.045 and p<0.001, respectively) and plasma levels of monocyte chemoattractant protein-1 by 3+/-27% and by 9+/-16%, respectively (p=0.113 and p=0.001, respectively). The C-reactive protein were also reduced, relative to baseline measurements, by 17+/-75% and by 17+/-37%, respectively (p=0.003 and p=0.001, respectively). However, simvastatin combined with ramipril changed, to a greater extent, but was statistically insignificant, the percentage of the flow-mediated dilator response to hyperemia, and the plasma monocyte chemoattractant protein-1 levels, than simvastatin alone.
CONCLUSION
Compared with simvastatin alone, the addition of ramipril improved the endothelial function to greater extent, but was statistically insignificant, in hypercholes-terolemic patients.

Keyword

HMG-CoA Reductase inhibitor; Angiotensin converting enzyme inhibitor; Endothelial function

MeSH Terms

C-Reactive Protein
Chemokine CCL2
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hyperemia
Inflammation*
Lipoproteins
Malondialdehyde
Nitric Oxide*
Plasma
Ramipril*
Simvastatin*
C-Reactive Protein
Chemokine CCL2
Lipoproteins
Malondialdehyde
Nitric Oxide
Ramipril
Simvastatin