In the meta-regression analysis , changes in plasma cortisol concentrations following statin therapy were found to be independent of treatment duration .
Results of this meta- analysis of RCTs suggest a significant elevation in plasma cortisol levels following statin therapy
This study aim ed to perform a systematic review and meta- analysis of r and omized controlled trials ( RCTs ) in order to calculate the effect size of statin therapy in changing plasma cortisol concentrations .
Simvastatin Versus Ezetimibe: Pleiotropic and Lipid-Lowering Effects on Endothelial Function in Humans
Background —Statins may exert important pleiotropic effects , ie , improve endothelial function , independently of their impact on LDL cholesterol . In humans , however , pleiotropic effects of statins have never been unequivocally demonstrated because prolonged statin treatment always results in reduced LDL cholesterol levels . We therefore tested the hypothesis that similar reductions in LDL cholesterol with simvastatin and ezetimibe , a novel cholesterol absorption inhibitor , result in different effects on endothelial function . Methods and Results —Twenty patients with chronic heart failure were r and omized to 4 weeks of simvastatin ( 10 mg/d ) or ezetimibe ( 10 mg/d ) treatment . Flow-dependent dilation ( FDD ) of the radial artery was determined by high-resolution ultrasound before and after intra-arterial vitamin C to determine the portion of FDD inhibited by radicals ( ΔFDD-VC ) . Activity of extracellular superoxide dismutase , a major vascular antioxidant enzyme system , was determined after release from the endothelium by a heparin bolus injection . Endothelial progenitor cells were analyzed with an in vitro assay . Simvastatin and ezetimibe treatment reduced LDL cholesterol to a similar extent ( 15.6 % versus 15.4 % ; P = NS ) , whereas changes in mevalonate , the product of HMG-CoA-reductase , differed between groups ( Δmevalonate-simvastatin , −1.04±0.62 versus Δmevalonate-ezetimibe , 1.79±0.94 ng/mL ; P<0.05 between groups ) . Importantly , FDD was markedly improved after simvastatin ( 10.5±0.6 % versus 5.1±0.7 % ; P<0.01 ) but not after ezetimibe treatment ( 5.6±0.5 % versus 5.8±0.6 % ; P = NS ) . ΔFDD-VC was substantially reduced after simvastatin but not after ezetimibe treatment . Extracellular superoxide dismutase activity was increased by > 100 % ( P<0.05 ) after simvastatin but not ezetimibe treatment . Simvastatin treatment increased the number of functionally active endothelial progenitor cells , whereas ezetimibe had no effect . Conclusions —Four weeks of simvastatin treatment improves endothelial function independently of LDL cholesterol lowering , at least in part by reducing oxidant stress . Simvastatin may thereby exert important pleiotropic effects in humans
In the meta-regression analysis , changes in plasma cortisol concentrations following statin therapy were found to be independent of treatment duration .
Results of this meta- analysis of RCTs suggest a significant elevation in plasma cortisol levels following statin therapy
This study aim ed to perform a systematic review and meta- analysis of r and omized controlled trials ( RCTs ) in order to calculate the effect size of statin therapy in changing plasma cortisol concentrations .