EFFECTS OF COMBINED TREATMENT WITH VALSARTAN AND FLUVASTATIN ON CAROTID INTIMA-MEDIAL ELASTICITY MEASURED BY A TRANSCUTANEOUS ULTRASONIC-BASED TISSUE CHARACTERIZATION SYSTEM: PP.2.65:

Objective: We previously reported an ARB, valsartan showed stabilizing effects on the distortion in the intramural elasticity distribution prior to IMT decrement. We investigated the effects of combined treatment with valsartan and a statin, fluvastatin on the carotid arterial elastic modulus in patients with essential hypertension (EH) and hypercholesterolemia (HC). Methods: The twenty patients (average age: 57 years old) with EH and HC were randomized to treatment with valsartan 80 mg/day (n = 10) or with valsartan 80 mg/day plus fluvastatin 30 mg/day (n = 10) for 12 months. The intima-media thickness (IMT) and elastic modulus in the circumferential direction (Eθ) were simultaneously measured by the high-resolution Doppler technique, “Phased Tracking Method”, in the area with maximum IMT less than 1.1 mm. Serum markers, urinary excretion 8-hydroxydeoxyguanosine (8-OHdG) and brachial-ankle pulse wave velocity (baPWV) were also examined. Results: The mean IMT and mean Eθ at baseline were 0.72±0.11 mm, 187.7±70.7 kPa, respectively, and the spatial distribution pattern of Eθ was scattered and heterogeneous. After 6 months, valsartan decreased blood pressure, Eθ, hsCRP, 8-OHdG and brachial-ankle pulse wave velocity significantly (p < 0.05) but IMT did not change in the two groups. Fluvastatin treatment significantly reduced LDL-C after 1 month. Coadministration of fluvastatin and valsartan showed a significant decrease of Eθ compared with the treatment of valsartan for 12 months (−23% vs −16%, p < 0.05). The histogram analysis of the data revealed both of the drugs decreased harder components of the elasticity distribution, suggesting improvement of endothelial dysfunction. Conclusions: Our results indicate that fluvastatin may have a synergistic effect on that of valsartan to improve the distortion in the intramural elasticity distribution in carotid arteries in patients with hypertension and hypercholesterolemia. The measurement of the carotid elastic modulus may be useful to evaluate the efficacy of drugs for improving regional atherosclerotic changes.