Sustained improvement of arterial stiffness and blood pressure after long-term rosuvastatin treatment in patients with inflammatory joint diseases: Results from the rora-as study

Abstract

Objective: Patients with inflammatory joint diseases (IJD) have a high prevalence of hypertension and increased arterial stiffness. The aim of the present study was to evaluate the effect of longterm rosuvastatin treatment on arterial stiffness, measured by augmentation index (AIx) and aortic pulse wave velocity (aPWV), and blood pressure (BP) in IJD patients with established atherosclerosis. Methods: Eighty-nine statin naïve IJD patients with carotid atherosclerotic plaque(s) (rheumatoid arthritis n = 55, ankylosing spondylitis n = 23, psoriatic arthritis n = 11) received rosuvastatin for 18 months to achieve low-density lipoprotein cholesterol goal <1.8 mmol/L Change in AIx (AAIx), aPWV (AaPWV), systolic BP (AsBP) and diastolic BP (AdBP) from baseline to study end was assessed by paired samples t-tests. Linear regression was applied to evaluate associations between cardiovascular disease (CVD) risk factors, rheumatic disease specific variables and medication, and AAIx, AaPWV, AsBP and AdBP. Results: AIx, aPWV, sBP and dBP were significantly reduced from baseline to study end. The mean (95%CI) changes were: AAIx: -0.34 (-0.03, -0.65)% (p = 0.03), AaPWV: -1.69 (-0.21, -3.17) m/s2 (p = 0.03), ΔsBP: -5.27 (-1.61, -8.93)mmHg (p = 0.004) and AdBP -2.93 (-0.86, -5.00) mmHg (p = 0.01). In linear regression models, AaPWV was significantly correlated with ΔsBP and ΔdBP (for all: p>0.001). Conclusions: There is an unmet need of studies evaluating CVD prevention in IJD patients. We have shown for the first time that long-term intensive lipid lowering with rosuvastatin improved arterial stiffness and induced a clinically significant BP reduction in patients with IJD. These improvements were linearly correlated and may represent novel insight into the pleiotropic effects by statins.