Difference in early effects of statin therapy on coronary and forearm flow reserve in postmenopausal hypercholesterolemic women

Abstract

Background: The relationships between flow reserves in coronary and peripheral circulation and their modification by statin therapy have not been assessed in the same patients, especially females. Methods and Results: To assess the effect of pravastatin on both circulation, in 20 postmenopausal female patients with hypercholesterolemia but a low probability of coronary artery disease, the forearm blood flow reserve (FBFR) using the plethysmographic method and coronary flow velocity reserve (CFVR) by Doppler echocardiography were measured before, 4 and 8 weeks after starting the pravastatin and/or diet therapy. At baseline, CFVR and FBFR had a positive linear correlation (r=0.63, p<0.01) while each of them had a negative linear correlation (r=-0.53 to -0.63, p<0.05 each) with total or LDL-cholesterol levels. Four weeks after starting the pravastatin therapy when the decrease in total cholesterol reached a plateau, FBFR increased (p<0.05) by 38±14%, whereas CFVR did not. Such an increase in FBFR by pravastatin was related to the degree of total or LDL-cholesterol lowering. Conclusions: In postmenopausal hypercholesterolemic women with a low probability of coronary artery disease, the cholesterol-lowering with pravastatin improved FBFR as early as 4 to 8 weeks after starting the therapy, whereas its effect on CFVR was unclear at that time.