The Effect of Statin Therapy on Arterial Stiffness by Measuring Pulse Wave Velocity: A Systematic Review

Objective: Pulse wave velocity (PWV) is a method to estimate arterial stiffness. Statins have been shown to improve the compliance of the vasculature. We present the available data from randomized controlled trials (RCTs) on the effect of statin administration on arterial stiffness by measuring PWV. Methods: We considered all RCTs evaluating PWV following the administration of statins. We searched PubMed up to July 2009. Information regarding the author, journal, year of publication, randomization method, participant characteristics, treatment intervention, PWV assessment, and outcome were recorded independently by two investigators. Results: We found 9 eligible studies with 471 participants. The most frequent comparison was between fluvastatin against placebo, and the most extensively studied agent was also fluvastatin (n = 4 trials, total population = 240). The most frequent indication for statin therapy was hyperlipidaemia (n = 6), with or without other cardiovascular risk factors. Aortic PWV, which is considered to be the most appropriate method for PWV evaluation, was assessed in 4 studies, with significant reduction (improvement of arterial stiffness) in 2 studies, a non-significant change in one study and a significant increase in the other. Peripheral (mainly brachial-ankle) PWV was assessed in the other 5 studies with significant reduction in all except the one multi-arm study where only fluvastatin improved PWV. Conclusions: We cannot safely conclude for the effect of statins on arterial stiffness, as estimated by PWV measurements. This is a poorly investigated field with few RCTs and a limited number of participants. More trials should be carried out to reach more robust conclusions.