|
|
||||||||||
|
J Am Coll Cardiol, 2002; 40:2117-2121 © 2002 by the American College of Cardiology Foundation |
,
,*
,




* Emma Childrens Hospital, AMC, Amsterdam, Netherlands
Department of Vascular Medicine, Academic Medical Center Amsterdam, Netherlands
Wilhelmina Childrens Hospital, Utrecht, Netherlands
Manuscript received March 18, 2002; revised manuscript received June 6, 2002, accepted July 18, 2002.
* Reprint requests and correspondence: Dr. Saskia de Jongh, Department of Vascular Medicine, Academic Medical Center, G1-146, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, Netherlands.
s.dejongh{at}amc.uva.nl
OBJECTIVES: This study was designed to determine whether simvastatin improves endothelial function in children with familial hypercholesterolemia (FH).
BACKGROUND: Endothelial function measured by flow-mediated dilation of the brachial artery (FMD) is used as a surrogate marker of cardiovascular disease (CVD). Adult studies have shown that statins reverse endothelial dysfunction and therefore reduce the risk for future CVD.
METHODS: The study included 50 children with FH (9 to 18 years) and 19 healthy, non-FH controls. Children with FH were randomized to receive simvastatin or placebo for 28 weeks. The FMD was performed at baseline and at 28 weeks of treatment.
RESULTS: At baseline, FMD was impaired in children with FH versus non-FH controls (p < 0.024). In the simvastatin FH group, FMD improved significantly, whereas the FMD remained unaltered in the placebo FH group throughout the study period (absolute increase 3.9% ± 4.3% vs. 1.2% ± 3.9%, p < 0.05). In the simvastatin FH group, FMD increased to a level similar to the non-FH controls (15.6% ± 6.8% vs. 15.5% ± 5.4%, p = 0.958). Upon treatment, the simvastatin FH group showed significant absolute reductions of total cholesterol (TC) (2.16 ± 1.04 mmol/l, 30.1%) and low-density lipoprotein cholesterol (LDL-C) (2.13 ± 0.99 mmol/l, 39.8%). The absolute change of FMD after 28 weeks of therapy was inversely correlated to changes of TC (r = 0.31, p < 0.05) and LDL-C (r = 0.31, p < 0.05).
CONCLUSIONS: Our data show significant improvement of endothelial dysfunction towards normal levels after short-term simvastatin therapy in children with FH. These results emphasize the relevance of statin therapy in patients with FH at an early stage, when the atherosclerotic process is still reversible.
| ||||||||||||||||||||||||
This article has been cited by other articles:
![]() |
D. Kamerow Should we screen for and treat childhood dyslipidaemia? BMJ, July 23, 2008; 337(jul23_2): a886 - a886. [Full Text] |
||||
![]() |
B. Fernhall and S. Agiovlasitis Arterial function in youth: window into cardiovascular risk J Appl Physiol, July 1, 2008; 105(1): 325 - 333. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. R. Daniels, F. R. Greer, and and the Committee on Nutrition Lipid Screening and Cardiovascular Health in Childhood Pediatrics, July 1, 2008; 122(1): 198 - 208. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. C. McGill Jr, C. A. McMahan, and S. S. Gidding Preventing Heart Disease in the 21st Century: Implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study Circulation, March 4, 2008; 117(9): 1216 - 1227. [Full Text] [PDF] |
||||
![]() |
C. G. Magnussen, O. T. Raitakari, R. Thomson, M. Juonala, D. A. Patel, J. S.A. Viikari, J. Marniemi, S. R. Srinivasan, G. S. Berenson, T. Dwyer, et al. Utility of Currently Recommended Pediatric Dyslipidemia Classifications in Predicting Dyslipidemia in Adulthood: Evidence From the Childhood Determinants of Adult Health (CDAH) Study, Cardiovascular Risk in Young Finns Study, and Bogalusa Heart Study Circulation, January 1, 2008; 117(1): 32 - 42. [Abstract] [Full Text] [PDF] |
||||
![]() |
American Diabetes Association Standards of Medical Care in Diabetes--2008 Diabetes Care, January 1, 2008; 31(Supplement_1): S12 - S54. [Full Text] [PDF] |
||||
![]() |
P. A. Stapleton, Adam. G. Goodwill, M. E. James, and J. C. Frisbee Altered mechanisms of endothelium-dependent dilation in skeletal muscle arterioles with genetic hypercholesterolemia Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2007; 293(3): R1110 - R1119. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. F. Green Summary of Workgroup Meeting on Use of Family History Information in Pediatric Primary Care and Public Health Pediatrics, September 1, 2007; 120(SUPPLEMENT_2): S87 - S100. [Abstract] [Full Text] [PDF] |
||||
![]() |
H.J. Avis, M.N. Vissers, E.A. Stein, F.A. Wijburg, M.D. Trip, J.J.P. Kastelein, and B.A. Hutten A Systematic Review and Meta-Analysis of Statin Therapy in Children With Familial Hypercholesterolemia Arterioscler. Thromb. Vasc. Biol., August 1, 2007; 27(8): 1803 - 1810. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. M. Haney, L. H. Huffman, C. Bougatsos, M. Freeman, R. D. Steiner, and H. D. Nelson Screening and Treatment for Lipid Disorders in Children and Adolescents: Systematic Evidence Review for the US Preventive Services Task Force Pediatrics, July 1, 2007; 120(1): e189 - e214. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. W. McCrindle and for the Writing Group Summary of the American Heart Association's Scientific Statement on Drug Therapy of High-Risk Lipid Abnormalities in Children and Adolescents Arterioscler. Thromb. Vasc. Biol., May 1, 2007; 27(5): 982 - 985. [Full Text] [PDF] |
||||
![]() |
B. W. McCrindle, E. M. Urbina, B. A. Dennison, M. S. Jacobson, J. Steinberger, A. P. Rocchini, L. L. Hayman, and S. R. Daniels Drug Therapy of High-Risk Lipid Abnormalities in Children and Adolescents: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, With the Council on Cardiovascular Nursing Circulation, April 10, 2007; 115(14): 1948 - 1967. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Strazzullo, S. M. Kerry, A. Barbato, M. Versiero, L. D'Elia, and F. P. Cappuccio Do Statins Reduce Blood Pressure?: A Meta-Analysis of Randomized, Controlled Trials Hypertension, April 1, 2007; 49(4): 792 - 798. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Belay, P. F. Belamarich, and C. Tom-Revzon The Use of Statins in Pediatrics: Knowledge Base, Limitations, and Future Directions Pediatrics, February 1, 2007; 119(2): 370 - 380. [Abstract] [Full Text] [PDF] |
||||
![]() |
R.-E. W. Kavey, V. Allada, S. R. Daniels, L. L. Hayman, B. W. McCrindle, J. W. Newburger, R. S. Parekh, and J. Steinberger Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics Circulation, December 12, 2006; 114(24): 2710 - 2738. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. C. Reis, K. E. Kip, O. C. Marroquin, M. Kiesau, L. Hipps Jr, R. E. Peters, and S. E. Reis Screening Children to Identify Families at Increased Risk for Cardiovascular Disease Pediatrics, December 1, 2006; 118(6): e1789 - e1797. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Kapiotis, G. Holzer, G. Schaller, M. Haumer, H. Widhalm, D. Weghuber, B. Jilma, G. Roggla, M. Wolzt, K. Widhalm, et al. A Proinflammatory State Is Detectable in Obese Children and Is Accompanied by Functional and Morphological Vascular Changes Arterioscler. Thromb. Vasc. Biol., November 1, 2006; 26(11): 2541 - 2546. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. S. Gidding New Cholesterol Guidelines for Children? Circulation, September 5, 2006; 114(10): 989 - 991. [Full Text] [PDF] |
||||
![]() |
J. Rodenburg, M. N. Vissers, A. Wiegman, E. R. Miller, P. M. Ridker, J. L. Witztum, J. J.P. Kastelein, and S. Tsimikas Oxidized Low-Density Lipoprotein in Children With Familial Hypercholesterolemia and Unaffected Siblings: Effect of Pravastatin J. Am. Coll. Cardiol., May 2, 2006; 47(9): 1803 - 1810. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. A. Miettinen, M. Railo, M. Lepantalo, and H. Gylling Reply J. Am. Coll. Cardiol., April 4, 2006; 47(7): 1497 - 1498. [Full Text] [PDF] |
||||
![]() |
O. T. Raitakari, T. Ronnemaa, M. J. Jarvisalo, T. Kaitosaari, I. Volanen, K. Kallio, H. Lagstrom, E. Jokinen, H. Niinikoski, J. S.A. Viikari, et al. Endothelial Function in Healthy 11-Year-Old Children After Dietary Intervention With Onset in Infancy: The Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) Circulation, December 13, 2005; 112(24): 3786 - 3794. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. T. Mallare, A. H. Karabell, P. Velasquez-Mieyer, S. R.S. Stender, and M. L. Christensen Current and Future Treatment of Metabolic Syndrome and Type 2 Diabetes in Children and Adolescents Diabetes Spectr, October 1, 2005; 18(4): 220 - 228. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Charakida, A. E. Donald, H. Green, C. Storry, M. Clapson, M. Caslake, D. T. Dunn, J. P. Halcox, D. M. Gibb, N. J. Klein, et al. Early Structural and Functional Changes of the Vasculature in HIV-Infected Children: Impact of Disease and Antiretroviral Therapy Circulation, July 5, 2005; 112(1): 103 - 109. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Wiegman, B. A. Hutten, E. de Groot, J. Rodenburg, H. D. Bakker, H. R. Buller, E. J. G. Sijbrands, and J. J. P. Kastelein Efficacy and Safety of Statin Therapy in Children With Familial Hypercholesterolemia: A Randomized Controlled Trial JAMA, July 21, 2004; 292(3): 331 - 337. [Abstract] [Full Text] [PDF] |
||||
![]() |
O. Greene and P. Durrington Clinical management of children and young adults with heterozygous familial hypercholesterolaemia in the UK J R Soc Med, May 1, 2004; 97(5): 226 - 229. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Gielen and R. Hambrecht The Childhood Obesity Epidemic: Impact on Endothelial Function Circulation, April 27, 2004; 109(16): 1911 - 1913. [Full Text] [PDF] |
||||
![]() |
M. J. Jarvisalo, M. Raitakari, J. O. Toikka, A. Putto-Laurila, R. Rontu, S. Laine, T. Lehtimaki, T. Ronnemaa, J. Viikari, and O. T. Raitakari Endothelial Dysfunction and Increased Arterial Intima-Media Thickness in Children With Type 1 Diabetes Circulation, April 13, 2004; 109(14): 1750 - 1755. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. M. Engler, M. B. Engler, M. J. Malloy, E. Y. Chiu, M. C. Schloetter, S. M. Paul, M. Stuehlinger, K. Y. Lin, J. P. Cooke, J. D. Morrow, et al. Antioxidant Vitamins C and E Improve Endothelial Function in Children With Hyperlipidemia: Endothelial Assessment of Risk from Lipids in Youth (EARLY) Trial Circulation, September 2, 2003; 108(9): 1059 - 1063. [Abstract] [Full Text] [PDF] |
||||
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |