Evaluation of the Effects of Atorvastatin on the Treatment of Secondary Pulmonary Hypertension due to Chronic Obstructive Pulmonary Diseases: A Randomized Controlled Trial

Abstract

Background: Since pulmonary hypertension (PH) in patients with chronic obstructive pulmonary diseases (COPD) causes poor prognosis and inflammatory process involved in PH, it is supposed that Statins with anti-inflammatory effects might be useful in the treatment of PH.

Objectives: The aim of this study was to evaluate the influence of Atorvastatin on the treatment of pulmonary hypertension in patients with COPD.

Patients and methods: A registered (IRCT201108257411N1), triple-blind, randomized controlled trial was performed in Rasoule Akram hospital, Tehran, from 2009 to 2011. Forty five patients with secondary pulmonary hypertension due to COPD were recruited and randomized to two groups receiving either Atorvastatin 40 mg/d or placebo in addition to their current treatment for 6 months. The outcomes including systolic pulmonary arterial hypertension (SPAH), cardiac output (CO), right ventricular size (RVS), CRP, 6 min walk distance test (6MWD), and spirometry parameters were measured after 6 months.

Results: Baseline characteristics were similar in both groups. After 6 months, pulmonary hypertension changed from 48.5 ± 6.9 to 42.9 ± 9.3 mmHg for Atorvastatin users and from 49.7 ± 11.4 to 48.2 ± 14.6 mmHg for Placebo users (P = 0.19, CI - 13.57 - 2.89), 6MWD after 6 months was 339 ± 155 meters in case group versus 340 ± 106 meters in control group (P = 0.98, CI - 92.58 - 91.15). There were no significant changes in other outcomes including CRP, RVS, CO and spirometry parameters.

Conclusions: Although we found a trend towards decreasing SPAH and improving 6MWD, no statistically significant shift were detected in our outcomes due to inadequate sample size.

Keywords: Chronic Obstructive Pulmonary Diseases (COPD); Hypertension, Pulmonary; Statin.

Figure 1.. Schematic Overview of Study