Effect of lifestyle and/or statin treatment on soluble markers of atherosclerosis in hypertensives

Objectives. To investigate the independent and combined effects of lifestyle changes and statin treatment on soluble markers of atherosclerotic activity. Design. The study was a randomised, 2 x 2 factorial 1 year intervention trial. Participants ( n = 177) were sedentary, drug-treated, hypertensive men ( aged 40-74 years). They were randomised to placebo, lifestyle intervention ( diet and physical activity), fluvastatin 40 mg, or the combination of lifestyle and fluvastatin. Results. Lifestyle intervention significantly reduced intercellular adhesion molecule-1 ( sICAM-1) compared to usual care ( p = 0.003). Thrombomodulin level remained higher among individuals receiving lifestyle intervention ( p = 0.025). sICAM-1 was less reduced among fluvastatin treated participants compared to the placebo treated ( p = 0.029). Changes of blood pressure, weight or waist circumference were not significantly different between treatment groups. Individuals who achieved improvement of classical risk factors also had a significant reduction of endothelial markers ( E-selectin, von Willebrands factor, tissue plasminogen activator antigen). Conclusions. One year of lifestyle intervention reduced the level of sICAM-1 in sedentary, drug-treated hypertensives, in spite of no impact on traditional risk factors. Low dose fluvastatin had no beneficial effect on the measured markers.