고혈압을 동반한 고콜레스테롤혈증환자에서 콜레스테롤 강하 효과가 혈관내피세포에 미치는 영향
Lipid-lowering Effect on Vascular Endothelium,
강영란 (Kang, Young-Ran, 경상대학교병원)
- Subject Hypertension , Hypercholesterolemia , HMG Co-A reductase inhibitors , Endothelial function
- Publisher 경상대학교 대학원
- Adviser 박성지
- Issued 2006
- Awarded 2006. 2
- Thesis degree 석사
- Major 대학원 의학과
- Specialty 내과학전공
- Page ix, 39
- Language 한국어
- Background: Endothelial dysfunction is an important early sign of atherosclerosis. Atherosclerosis is common finding in hypercholesterolemic hypertensive patients. Whether lowering serum lipid level in these patients, especially by cholestyramine, do benefit in endothelial function is not known. ...
- Background: Endothelial dysfunction is an important early sign of atherosclerosis. Atherosclerosis is common finding in hypercholesterolemic hypertensive patients. Whether lowering serum lipid level in these patients, especially by cholestyramine, do benefit in endothelial function is not known. We performed a randomized, double-blinded, placebo-controlled study to assess the lipid-lowering effect by statin and cholestyramine on endothelial function. Methods: Sixty-nine patients with hypercholesterolemia and hypertensioin were randomized to receive pravastatin 40mg (pravastatin group, n=27), cholestyramine resin 16g (cholestyramine group, n=20) or placebo (control group, n=22) for 8 weeks. To estimate the endothelial function, flow-mediated dilatation(FMD) and nitroglycerin-mediated dilatation(NMD) were measured in brachial artery by using vascular ultrasound at start and the end of this study respectively. Plasma WBC, ESR, interleukin-6(IL-6) and high sensitivity C-reactive protein(hs-CRP) were measured as inflammatory markers at the same time. Results : During therapy, total cholesterol decreased in pravastatin group and cholestyramine group, by 17.1±14 % and by 17±10 % (both p<0.001). LDL cholesterol decreased by 23.2±18 % and by 25.3±25 % (both p<0.001). IL-6 and hs-CRP level were decreased significantly (from 1.68±2.1 pg/mL to 0.65±0.47 pg/mL, 1.54±1.8 mg/L to 203±28 mg/L respectively, p<0.001). FMD improved from 5.5±4 % to 8.9±3 % in pravastatin group (p<0.001) and from 3.5±2 % to 9.4±3 % in cholestyramine group (p<0.001). The change of FMD extent in pravastatin group and cholestyramine group was negatively correlated with the extent of decrease in LDL cholesterol level and hs-CRP( r=-0.42, p<0.05, r=-0.38 p<0.05 respectively) Conclusions: Endothelial function measured by FMD in hypercholesterolemic hypertensive patients was improved by decreasing serum LDL level and controling endothelial inflammation with pravastatin and cholestyramine.