Hypercholesterolemia is associated with impaired endothelial function,
1
,
- Vita J.A.
- Treasure C.B.
- Yeung A.C.
- Vekshtein V.I.
- Fantasia G.M.
- Fish R.D.
- Ganz P.
- Selwyn A.P.
Patients with evidence of coronary endothelial dysfunction as assessed by acetylcholine
infusion demonstrate marked increase in sensitivity to constrictor effects of catecholamines.
Circulation. 1992; 85: 1390-1397
2
and animal
3
,
4
and human
5
,
6
,
7
studies indicate that lipid-lowering improves endothelial function. Current National
Cholesterol Education Program (NCEP) Adult Treatment Panel II guidelines consider
desirable low-density lipoprotein (LDL) cholesterol levels in patients with coronary
artery disease (CAD) to be ≤100 mg/dl,
8
although recent trials using statin lipid-lowering treatment in patients with CAD
have suggested there is no longitudinal benefit of lipid lowering among patients with
baseline LDL cholesterol <125 mg/dl.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in
Adults
Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).
Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).
JAMA. 1993; 269: 3015-3023
9
,
- Sacks F.M.
- Pfeffer M.A.
- Moye L.A.
- Rouleau J.R.
- Rutherford J.D.
- Cole T.G.
- Brown L.
- Wornica J.W.
- Arnold J.M.O.
- Wun C.C.
- Davis B.R.
- Braunwald E.
The effect of pravastatin on coronary events after myocardial infarction in patients
with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators.
N Engl J Med. 1996; 335: 1001-1009
10
Although coronary angiographic trials suggest that more intensive intervention (i.e.,
LDL cholesterol <100 mg/dl) is associated with improved results in terms of the regression
or arrest of progression of coronary lesions compared with more moderate LDL cholesterol
reduction,
11
no trial has directly assessed whether there is mortality benefit from lowering LDL
cholesterol levels to the NCEP goal of 100 mg/dl. To determine whether achievement
of the current NCEP cholesterol recommendations are consistent with beneficial endothelium-dependent
vasodilatation, we assessed endothelium-dependent brachial artery vasoreactivity noninvasively
in stable CAD patients. We hypothesized that achievement of LDL cholesterol ≤100 mg/dl
would be associated with more beneficial endothelial vasoreactivity than LDL cholesterol
>100 mg/dl in patients with CAD.To read this article in full you will need to make a payment
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References
- Patients with evidence of coronary endothelial dysfunction as assessed by acetylcholine infusion demonstrate marked increase in sensitivity to constrictor effects of catecholamines.Circulation. 1992; 85: 1390-1397
- Impaired endothelium-dependent vasodilation of forearm resistance vessels in hypercholesterolemia.Lancet. 1992; 340: 1430-1432
- The effect of cholesterol reduction on the endothelial function and progression of atherosclerisis in WHHL rabbits.Atherosclerosis. 1993; 103: 221-230
- Lack of endothelium-dependent relaxation in coronary resistance arteries of cholesterol-fed rabbits.Am J Physiol. 1989; 256: C591-C597
- Beneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients with coronary artery disease.N Engl J Med. 1995; 332: 481-487
- Beneficial effect of cholesterol-lowering therapy on coronary endothelium-dependent relaxation in hypercholesterolemic patients.Lancet. 1993; 341: 1496-1500
- Vascular function in the forearm of hypercholesterolemic patients off and on lipid-lowering medication.Lancet. 1995; 346: 467-471
- Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).JAMA. 1993; 269: 3015-3023
- The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators.N Engl J Med. 1996; 335: 1001-1009
- Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and broad range of initial cholesterol levels.N Engl J Med. 1998; 339: 1349-1357
- The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts.N Engl J Med. 1997; 336: 153-162
- Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis.Lancet. 1992; 340: 1111-1115
- Technical aspects of evaluating brachial artery vasodilation using high frequency ultrasound.Am J Physiol. 1995; 268: H1397-H1404
- Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clin Chem. 1972; 18: 499-502
- The effect of cholesterol-lowering and antioxidant therapy on endothelium-dependent coronary vasomotion.N Engl J Med. 1995; 332: 488-493
- Single apheresis improves endothelium-dependent vasodilatation in hypercholesterolemic humans.Circulation. 1997; 95: 76-82
- Changes in flow-mediated brachial artery vasoactivity with lowering of desirable cholesterol levels in healthy middle-aged men.Am J Cardiol. 1996; 77: 37-40
- Statins do more than just lower cholesterol.Lancet. 1996; 348: 1079-1082
- Serum cholesterol as a prognostic factor after myocardial infarction.Ann Intern Med. 1991; 115: 687-693
Article info
Publication history
Published online: August 16, 2004
Accepted:
June 20,
2000
Received in revised form:
June 20,
2000
Received:
March 21,
2000
Footnotes
☆This study was supported in part by Save A Heart Foundation, Los Angeles, California and Asta Medica Company, Inc., Vienna, Austria.
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
