The differential effect of statins on oxidative stress and endothelial function: Atorvastatin versus pravastatin

Jonathan R. Murrow, Salman Sher, Sarfraz Ali, Irina Uphoff, Riyaz Patel, Marcus Porkert, Ngoc Anh Le, Dean Jones, Arshed A. Quyyumi

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Background: Atherogenic risk in subjects with metabolic syndrome is partly mediated by increased oxidative stress and subsequent endothelial dysfunction. Clinical trials have demonstrated differences in outcomes between subjects receiving lipophilic statins (atorvastatin) compared with hydrophilic statins (pravastatin). However, whether these findings are attributable to differences in the doses administered or to nonlipid-lowering pleiotropic effects of statins on oxidative stress and vascular function remains unknown. We hypothesized that equipotent doses of these two statins will have divergent effects on markers of oxidative stress and endothelial function. Methods: Thirty-six subjects with hyperlipidemia and metabolic syndrome and/or diabetes were randomized in a double-blind manner to either pravastatin 80 mg or atorvastatin 10 mg daily. Oxidative stress (dROMs assay that measures lipid hydroperoxides, plasma thiobarbituric acid reactive substances [TBARS], and aminothiol levels) and brachial artery flow-mediated dilation (FMD) were measured at baseline and after 12 weeks of statin therapy. Results: Statin therapy reduced serum low-density lipoprotein cholesterol levels equally in both groups. Atorvastatin therapy was associated with a significant reduction in TBARS (P =.006) and dROMs levels (P =.02), which was not observed in subjects treated with pravastatin. Endothelial function improved with statin therapy (P =.02), but there was no difference between the statin groups. Conclusion: In hyperlipidemic subjects with metabolic syndrome, atorvastatin is associated with a greater reduction in lipid markers of oxidation compared with pravastatin. Whether these effects are responsible for the outcome differences in trials comparing these agents needs further investigation.

Original languageEnglish (US)
Pages (from-to)42-49
Number of pages8
JournalJournal of Clinical Lipidology
Volume6
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

Keywords

  • Endothelial function
  • Metabolic syndrome
  • Oxidative stress
  • Statins

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

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