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      The Effects of Statins on Pulmonary Artery Pressure in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

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          Abstract

          Objective:

          Pulmonary hypertension is a serious complication in patients suffering from chronic obstructive pulmonary disease (COPD). The aim of this study is to investigate the effects of atorvastatin in reducing pulmonary arterial pressure in COPD patients.

          Methods:

          This double-blind, randomized trial was conducted on 42 known cases of COPD with systolic pulmonary arterial pressure of more than 25 mmHg. The patients were randomly assigned into two groups, 21 patients with atorvastatin treatment (40 mg/daily for 6 months) and 21 patients without receiving atorvastatin. All the patients participated voluntarily and provided written informed consent. The trial was registered in the Iranian Registry of Clinical Trials. Pulmonary pressure was also anticipated by Doppler echocardiography with peak pressure gradient of tricuspid regurgitation. Both groups were tested with echocardiography to measure systolic pulmonary pressure at baseline and posttreatment. Statistical analysis includes Chi-square, Student's t-test, and Wilcoxon test. P < 0.05 was considered statistically significant.

          Findings:

          The mean age was 65.8 ± 11.5 years for atorvastatin group and 63.7 ± 7.6 years for control group ( P = 0.45). Baseline and posttreatment mean systolic pulmonary artery pressure (PAP) levels in the atorvastatin group were 48.9 ± 3.3 and 38.4 ± 1.9 mmHg, respectively ( P = 0.007). In the control group, mean systolic PAP levels at baseline and 6 months later were 45.6 ± 3.1 and 38.9 ± 2.4 mmHg, respectively ( P = 0.073). The patients treated with atorvastatin showed significant decrease in total cholesterol ( P = 0.001) and low-density lipoprotein cholesterol ( P = 0.008).

          Conclusion:

          A 40 mg dose of atorvastatin daily for 6 months may have beneficial effects in reducing PAP in patients with COPD. Further studies are necessary to find long-term effects of statins in COPD patients.

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          Most cited references23

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          Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper.

          W MacNee, , B Celli (2004)
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            Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD.

            Chronic obstructive pulmonary disease (COPD) is associated with important chronic comorbid diseases, including cardiovascular disease, diabetes and hypertension. The present study analysed data from 20,296 subjects aged > or =45 yrs at baseline in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS). The sample was stratified based on baseline lung function data, according to modified Global Initiative for Obstructive Lung Disease (GOLD) criteria. Comorbid disease at baseline and death and hospitalisations over a 5-yr follow-up were then searched for. Lung function impairment was found to be associated with more comorbid disease. In logistic regression models adjusting for age, sex, race, smoking, body mass index and education, subjects with GOLD stage 3 or 4 COPD had a higher prevalence of diabetes (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.1-1.9), hypertension (OR 1.6, 95% CI 1.3-1.9) and cardiovascular disease (OR 2.4, 95% CI 1.9-3.0). Comorbid disease was associated with a higher risk of hospitalisation and mortality that was worse in people with impaired lung function. Lung function impairment is associated with a higher risk of comorbid disease, which contributes to a higher risk of adverse outcomes of mortality and hospitalisations.
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              Screening, early detection, and diagnosis of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines.

              Pulmonary arterial hypertension (PAH) occurs as an idiopathic process or as a component of a variety of disease processes, including chronic thromboembolic disease, connective tissue diseases, congenital heart disease, and exposure to exogenous factors including appetite suppressants or infectious agents such as HIV. This article reviews evidence for screening in susceptible patient groups and the approach to diagnosing PAH when it is suspected, and provides specific recommendations for applying this evidence to clinical practice.
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                Author and article information

                Journal
                J Res Pharm Pract
                J Res Pharm Pract
                JRPP
                Journal of Research in Pharmacy Practice
                Medknow Publications & Media Pvt Ltd (India )
                2319-9644
                2279-042X
                Jan-Mar 2017
                : 6
                : 1
                : 27-30
                Affiliations
                [1 ]Birjand Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
                [2 ]Department of Internal Medicine, Pulmonary Division, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran
                Author notes
                Address for correspondence: Dr. Sayyed Gholamreza Mortazavi Moghadam, E-mail: gmortazavi@ 123456yahoo.com
                Article
                JRPP-6-27
                10.4103/2279-042X.200985
                5348853
                85ab07c2-d2d1-45e0-a6d0-4a40d5e06774
                Copyright: © 2017 Journal of Research in Pharmacy Practice

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : October 2016
                : December 2016
                Categories
                Original Article

                atorvastatin,chronic obstructive pulmonary disease,pulmonary artery pressure

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