Short-term effect of rosuvastatin treatment on arterial stiffness in individuals with newly-diagnosed heterozygous familial hypercholesterolemia

Background: Pulse wave velocity (PWV) is considered a major indicator of arterial stiffness, which can be quickly modulated by therapeutic interventions. We sought to assess the short-term effect of rosuvastatin therapy on carotid-femoral PWV in statin-naïve individuals with heterozygous familial hypercholesterolemia (He-FH). Methods: In this prospective single-center open-label study, statin-naïve individuals with a probable or definite diagnosis of He-FH (Dutch Lipid Clinic Network score ≥ 6 including LDL-C ≥ 190 mg/dL), without clinical history of diabetes mellitus, coronary artery disease or chronic inflammatory diseases, underwent a clinical, biochemical and instrumental evaluation including carotid-femoral PWV assessment at baseline and after a 3-month treatment with rosuvastatin. Results: Among > 500 individuals screened for suspect He-FH in a 1.5-year period, 22 fulfilled our inclusion and exclusion criteria and were enrolled in the study. Twenty of them completed the 3-month treatment period and evaluations, including 7 men and 13 women, with a mean age of 45 ± 14 years. At 3-month follow-up there was a significant 46% reduction in LDL cholesterol (from 255.8 ± 42.1 to 138.6 ± 41.2, p < 0.0001). Concomitantly, we observed a significant 14% reduction in PWV (from 8.30 ± 1.4 to 7.13 ± 0.97 m/s, p < 0.0001), which persisted after adjusting for mean blood pressure and heart rate at the time of PWV assessment. There was no significant relationship between the change in PWV and in LDL cholesterol levels. Conclusions: Our preliminary results suggest that in individuals with He-FH, a 3-month treatment period with rosuvastatin determines a significant reduction in arterial stiffness, possibly through its pleiotropic vascular effect beyond lowering of plasma cholesterol.