Effects of different doses of atorvastatin on blood lipid level and endothelial function in patients with hypertension and carotid plaque / 中国基层医药

ABSTRACT

Objective:To compare the effects of different doses of atorvastatin on blood lipid and endothelial function in patients with hypertension and carotid plaque.Methods:Ninety-two patients with hypertension and carotid plaque who received treatment from June 2019 to June 2020 were included in this study. They were assigned to receive treatment with either atorvastatin 20 mg (control group, n = 46) or atorvastatin 40 mg (study group, n = 46) for 3 months. Blood lipid level and endothelial function were compared between the two groups. Results:There were no significant differences in sex, age, course of disease, body mass index (BMI) and carotid plaque grading between the two groups (all P > 0.05). Before treatment, there were no significant differences in serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) between two groups (all P > 0.05). After treatment, serum levels of TC, TG and LDL-C in each group were significantly decreased compared with before treatment [study group TC (5.8 ± 2.3) mmol/L vs. (3.5 ± 1.3) mmol/L, t = 5.904; TG (2.5 ± 0.8) mmol/L vs. (1.2 ± 0.5) mmol/L, t = 9.346; LDL-C (5.0 ± 0.4) mmol/L vs. (3.3 ± 0.4) mmol/L, t = 20.382; control group TC (5.9 ± 1.8) mmol/L vs. (4.5 ± 1.5) mmol/L, t = 4.052; TG (2.6 ± 0.3) mmol/L vs. (1.8 ± 0.7) mmol/L, t = 7.125; LDL-C (4.9 ± 0.5) mmol/L vs. (4.2 ± 0.5) mmol/L, t = 6.714, all P < 0.01). After treatment, serum level of HDL-C in each group was significantly increased compared with before treatment [study group (0.8 ± 0.5) mmol/L vs. (1.5 ± 0.3) mmol/L, t = 8.142; control group (0.8 ± 0.4) mmol/L vs. (1.3 ± 0.2) mmol/ L, t = 7.583, both P < 0.01]. After treatment, serum levels of TC, TG and LDL-C in the study group were significantly lower than those in the control group ( tTC = 3.417, tTG = 4.731, tLDL-C = 9.533, all P < 0.01). After treatment, serum level of HDL-C in the study group was significantly higher than that in the control group ( tHDL-C = 3.762, P < 0.01). Before treatment, there were no significant differences in endothelium-dependent (flow mediated dilation, FMD) and endothelium-independent diastolic function (nitroglycerin- mediated dilatation, NMD) between the two groups (both P > 0.05). After treatment, FMD in each group was significantly enhanced compared with before treatment [study group (7.5 ± 1.8) % vs. (10.9 ± 2.5) %, t = 7.486; control group (7.7 ± 1.5) % vs. (8.9 ± 2.2) %, t = 3.057; both P < 0.05]. After treatment, FMD in the study group was significantly higher than that in the control group ( t = 4.073, P < 0.01). There was no significant difference in NMD between before and after treatment in the control group. After treatment, NMD in the study group was significantly increased compared with before treatment [(12.5 ± 2.3) % vs. (13.6 ± 2.5) %, t = 2.196, P = 0.031]. Conclusion:Atorvastatin 40 mg once a day can effectively regulate blood lipid level and improve endothelial function in patients with hypertension and carotid plaque, which exhibits superior effects to atorvastatin 20 mg once a day.