Impaired NO-dependent vasodilation of resistance vessels is an early marker of an increased risk of atherosclerosis; utility of the examination of microcirculation, however, is far less established. We have therefore tested the hypothesis that hypercholesterolemia is associated with an impaired microvascular reactivity and that this defect is at least partially reversible by lipid-lowering treatment. Twenty-seven otherwise healthy patients with severe hypercholesterolemia (HLP) were examined at rest and then after 10 weeks of atorvastatin treatment (20 mg/day). Skin microvascular reactivity (MVR) was examined by laser-Doppler flowmetry. Baseline MVR values of the studied group were compared to healthy control subjects, HLP patients with coronary artery disease (CAD) and diabetic patients with and without diabetic retinopathy. MVR was normal in HLP subjects without CAD. On the contrary, MVR was impaired in HLP patients with CAD. There was no effect of atorvastatin on MVR, despite the profound reduction of serum lipids. MVR values did not correlate with cholesterol levels. In diabetic subjects, the MVR was substantially impaired only in patients with retinopathy. In the subjects without retinopathy, MVR was either normal (type I diabetes) or moderately impaired (type II diabetes). MVR was thus normal in HLP patients without manifest vascular disease and was not influenced by lipid lowering therapy. Impairment in the MVR was only evident in subjects with HLP and severe CAD. These results suggest that microcirculation is not involved in the early vascular dysfunction induced by HLP and that MVR rather reflects changes which appear later in the course of the atherosclerotic disease.

• MeSH
• Anticholesteremic Agents therapeutic use   MeSH
• Atorvastatin MeSH
• Diabetes Mellitus drug therapy   microbiology   MeSH
• Adult MeSH
• Hypercholesterolemia drug therapy   physiopathology   MeSH
• Hyperemia physiopathology   MeSH
• Skin blood supply   MeSH
• Heptanoic Acids therapeutic use   MeSH
• Laser-Doppler Flowmetry MeSH
• Cholesterol, LDL blood   MeSH
• Middle Aged MeSH
• Humans MeSH
• Microcirculation drug effects   physiology   MeSH
• Coronary Artery Disease physiopathology   MeSH
• Pilot Projects MeSH
• Pyrroles therapeutic use   MeSH
• Blood Component Removal MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Anticholesteremic Agents MeSH
• Atorvastatin MeSH
• Heptanoic Acids MeSH
• Cholesterol, LDL MeSH
• Pyrroles MeSH