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Mediators of Inflammation
Volume 2014, Article ID 423120, 10 pages
http://dx.doi.org/10.1155/2014/423120
Research Article

Response to Statin Therapy in Obstructive Sleep Apnea Syndrome: A Multicenter Randomized Controlled Trial

1University Grenoble Alpes, HP2, Inserm U1042, Grenoble, France
2CHU de Grenoble, Laboratoire EFCR, Clinique Universitaire de Physiologie, Grenoble, France
3Laboratoire EFCR, Pôle Thorax et Vaisseaux, CHU de GRENOBLE CS 10217, 38043 Grenoble, France
4CHU de Grenoble, Clinique de Cardiologie, Grenoble, France
5Laboratoire du Sommeil, Service de Neuropsychiatrie, Hôpital Belle Idée, Genève, Switzerland
6Laboratoire d’explorations Fonctionnelles Vasculaires, CHU d’Angers, Angers, France
7Service de Pneumologie, Hôpital Universitaire de Genève, Genève, Switzerland
8CHU d’Angers, Département de Pneumologie, Angers, France
9Université d’Angers, Inserm 1063 “SOPAM”, Angers, France
10CHU de Grenoble, Département de Biochimie, Toxicologie et Pharmacologie, Grenoble, France

Received 30 June 2014; Revised 23 July 2014; Accepted 25 July 2014; Published 25 August 2014

Academic Editor: David Gozal

Copyright © 2014 Marie Joyeux-Faure et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rationale. Accumulated evidence implicates sympathetic activation as inducing oxidative stress and systemic inflammation, which in turn lead to hypertension, endothelial dysfunction, and atherosclerosis in obstructive sleep apnea (OSA). Statins through their pleiotropic properties may modify inflammation, lipid profile, and cardiovascular outcomes in OSA. Methods. This multicenter, randomized, double-blind study compared the effects of atorvastatin 40 mg/day versus placebo over 12 weeks on endothelial function (the primary endpoint) measured by peripheral arterial tone (PAT). Secondary endpoints included office blood pressure (BP), early carotid atherosclerosis, arterial stiffness measured by pulse wave velocity (PWV), and metabolic parameters. Results. 51 severe OSA patients were randomized. Key demographics for the study population were age 54 ± 11 years, 21.6% female, and BMI 28.5 ± 4.5 kg/m2. In intention to treat analysis, mean PAT difference between atorvastatin and placebo groups was 0.008 (−0.29; 0.28), . Total and LDL cholesterol significantly improved with atorvastatin. Systolic BP significantly decreased with atorvastatin (mean difference: −6.34 mmHg (−12.68; −0.01), ) whereas carotid atherosclerosis and PWV were unchanged compared to the placebo group. Conclusion. In OSA patients, 3 months of atorvastatin neither improved endothelial function nor reduced early signs of atherosclerosis although it lowered blood pressure and improved lipid profile. This trial is registered with NCT00669695.