Effect of Simvastatin on Arterial Stiffness in Patients with Statin Myalgia

Abstract

Statins reduce arterial stiffness but are also associated with mild muscle complaints. It is unclear whether individuals with muscle symptoms experience the same vascular benefit or whether statins affect striated and smooth muscle cells differently. We examined the effect of simvastatin treatment on arterial stiffness in patients who did versus those who did not exhibit muscle symptoms. Patients with a history of statin-related muscle complaints (n=115) completed an 8 wk randomized, double-blind, cross-over trial of daily simvastatin 20 mg and placebo. Serum lipids and pulse wave velocity (PWV) were assessed before and after each treatment. Muscle symptoms with daily simvastatin treatment were reported by 38 patients (33%). Compared to baseline, central PWV decreased (P=0.01) following simvastatin treatment but not placebo (drug ∗ time interaction:P=0.047). Changes in central PWV with simvastatin treatment were not influenced by myalgia status or time on simvastatin (P≥0.15). Change in central PWV after simvastatin treatment was inversely correlated with age (r=-0.207,P=0.030), suggesting that advancing age is associated with enhanced statin-mediated arterial destiffening. In patients with a history of statin-related muscle complaints, the development of myalgia with short-term simvastatin treatment did not attenuate the improvement in arterial stiffness.