Atorvastatin increases exercise leg blood flow in healthy adults

Abstract

Objectives: We sought to examine the effect of atorvastatin therapy on exercise leg blood flow in healthy middle-aged and older-men and women.

Background: The vasodilatory response to exercise decreases in humans with aging and disease and this reduction may contribute to reduced exercise capacity.

Methods: We used a double-blind, randomly assigned, placebo-controlled protocol to assess the effect of atorvastatin treatment on exercising leg hemodynamics. We measured femoral artery blood flow (FBF) using Doppler ultrasound and calculated femoral vascular conductance (FVC) from brachial mean arterial pressure (MAP) before and during single knee-extensor exercise in healthy adults (ages 40-71) before (PRE) and after (POST) 6 months of 80 mg atorvastatin (A: 14 men, 16 women) or placebo (P: 14 men, 22 women) treatment. FBF and FVC were normalized to exercise power output and estimated quadriceps muscle mass.

Results: Atorvastatin reduced LDL cholesterol by approximately 50%, but not in the placebo group (p < 0.01). Atorvastatin also increased exercise FBF from 44.2 ± 19.0 to 51.4 ± 22.0 mL/min/W/kg muscle whereas FBF in the placebo group was unchanged (40.1 ± 16.0 vs. 39.5 ± 16.1) (p < 0.01). FVC also increased with atorvastatin from 0.5 ± 0.2 to 0.6 ± 0.2 mL/min/mmHg/W/kg muscle, but not in the placebo subjects (P: 0.4 ± 0.2 vs. 0.4 ± 0.2) (p < 0.01).

Conclusions: High-dose atorvastatin augments exercising leg hyperemia. Statins may mitigate reductions in the exercise vasodilatory response in humans that are associated with aging and disease.

Trial registration: ClinicalTrials.gov NCT00609063.

Figure 1

Effect of atorvastatin on resting leg hemodynamics. Group means ± SDs for resting FBF (Figure 1A), resting FBF normalized to estimated quadriceps muscle (Figure 1B), resting FVC (Figure 1C) and resting FVC normalized to estimated quadriceps muscle (Figure 1D). * indicates a significant (p < 0.05) pre-treatment difference between the placebo vs. atorvastatin group.

Figure 2

Effect of atorvastatin on exercising leg hemodynamics. Group means ± SDs for exercising FBF (Figure 2A), exercising FBF normalized to estimated quadriceps muscle (Figure 2B), exercising FVC (Figure 2C) and exercising FVC normalized to estimated quadriceps muscle (Figure 2D). Significant (p < 0.05) time*drug interactions are denoted on each panel, and † indicates a significant post-treatment difference between the placebo and atorvastatin group.