Back to Search Start Over

A clinical trial to evaluate the effect of statin use on lowering aldosterone levels.

Authors :
Hornik ES
Altman-Merino AE
Koefoed AW
Meyer KM
Stone IB
Green JA
Williams GH
Adler GK
Williams JS
Source :
BMC endocrine disorders [BMC Endocr Disord] 2020 Jul 14; Vol. 20 (1), pp. 105. Date of Electronic Publication: 2020 Jul 14.
Publication Year :
2020

Abstract

Background: Statins are the first-line pharmaceutical agent in the management of hypercholesterolemia and cardiovascular (CV) risk reduction, and the most commonly prescribed class of drugs worldwide. Studies describing CV risk reduction independent of LDL-cholesterol lowering have evoked an interest in the pleiotropic mechanisms of statins' benefits. We recently demonstrated that administration of statins in animal models lowers aldosterone levels and observed an association between statin use and reduced aldosterone levels in two human cohorts, with lipophilic statins displaying a greater effect than hydrophilic statins. Therefore, we designed a randomized, placebo-controlled, double-blinded intervention study to assess whether statin treatment lowers aldosterone in a type-dependent manner in humans, with simvastatin (lipophilic) showing a greater effect than pravastatin (hydrophilic).<br />Methods/design: One hundred five healthy participants will be recruited from the general population to enroll in a 12-week, randomized, placebo-controlled, double-blinded, 3-arm clinical trial. Ninety participants are anticipated to complete the protocol. After baseline assessment of aldosterone levels, participants will be randomized to daily simvastatin, pravastatin, or placebo. Aldosterone levels will be assessed after 2 days on study drug and again after 6 weeks and 12 weeks on study drug. Prior to each aldosterone assessment, participants will consume an isocaloric sodium and potassium-controlled run-in diet for 5 days. Assessments will occur on an inpatient research unit to control for diurnal, fasting, and posture conditions. The primary outcome will compare 12-week angiotensin II-stimulated serum aldosterone by study drug. Secondary outcomes will compare baseline and 12-week 24-h urine aldosterone by study drug.<br />Discussion: Results from this rigorous study design should provide strong support that statins lower aldosterone levels in humans. These results may explain some of the beneficial effects of statins that are not attributed to the LDL-lowering effect of this important class of medications. Results would demonstrate that statin lipophilicity is an important attribute in lowering aldosterone levels. The outcomes of this program will have implications for the design of studies involving statin medications, as well as for the differential use of classes of statins.<br />Trial Registration: ClinicalTrials.gov; NCT02871687 ; First Posted August 18, 2016.

Details

Language :
English
ISSN :
1472-6823
Volume :
20
Issue :
1
Database :
MEDLINE
Journal :
BMC endocrine disorders
Publication Type :
Academic Journal
Accession number :
32664962
Full Text :
https://doi.org/10.1186/s12902-020-00587-4