Differential associations of statin and fibrate treatment with carotid arterial remodeling

Background: The effects of statins on intima-media thickness (IMT) are well, documented, whereas those of fibrates are unknown. Therefore we compared IMT under treatment with each class of drugs. Methods: We studied a cohort of consecutive dyslipidemic subjects treated with statin (n = 29 1) or fibrate (n = 82) drugs. Fibrate-treated subjects were matched with the same number of statin-treated subjects to obtain two subgroups of similar demographic and risk factors including LDL cholesterol. Common carotid far wall IMT and lumen diameter were measured by ultrasonography. Results: In the entire study population, IMT was greater in the fibrate group than in the statin group (P <.001), even after adjustment for LDL cholesterol and other covariates (P <.05). In the matched groups, IMT was greater in fibrate group than in the statin group (P <.01), even after adjustment for LDL cholesterol and other covariates including treatment duration (P <.01). The IMT correlated positively with treatment duration in the fibrate group (P < 0.05) but not in the statin group. In addition, IMT correlated positively with carotid lumen diameter in both the fibrate and statin groups (P <.05, P <.01) but with a lower slope in the former (P <.05). Conclusions: In this study fibrate treatment was associated with greater IMT, steeper IMT-time relationship, and lower compensatory carotid enlargement than was statin treatment. These differences were not explained by differences in LDL cholesterol. Am J Hypertens 2005;18: 1476-1481 (c) 2005 American Journal of Hypertension, Ltd.