Why the study?
Does supplementary treatment with probucol or vitamin E improve resistance of LDL to oxidation and enhance vascular endothelial responses in hypercholesterolaemic patients on simvastatin?
Does supplementary treatment with probucol or vitamin E improve resistance of LDL to oxidation and enhance vascular endothelial responses in hypercholesterolaemic patients on simvastatin?
While probucol markedly increases LDL resistance to oxidation, neither probucol nor vitamin E improves forearm vascular endothelial responses in hypercholesterolemic patients.
Probucol and vitamin E fail to improve endothelial responses despite boosting LDL oxidation resistance; challenges oxidative modification hypothesis in statin-treated hypercholesterolemia.
This study investigates the hypothesis that lipid soluble antioxidants may increase the resistance of low-density lipoprotein (LDL) to oxidation and also enhance vascular endothelial responses in humans. In a double-blind parallel group study, 24 hypercholesterolaemic patients already on treatment with simvastatin (20 mg day-1), were randomized to supplementary treatment with probucol (500 mg bd), vitamin E (400 IU daily) or placebo for 8 weeks. Mean serum cholesterol before antioxidant treatment was 7.00 mmol l-1. Resistance of LDL to oxidation by copper was increased by 830% in the probucol group and by 30% in the vitamin E group. However, thiobarbituric acid reacting substances in whole serum were not altered by either antioxidant. Probucol lowered HDL- and LDL-cholesterol levels and increased the QT interval. Forearm vascular responses, as measured by venous occlusion plethysmography, to acetylcholine, glyceryl trinitrate and NG-monomethyl-L-arginine, were not significantly changed by antioxidant treatment. Probucol has a major, and vitamin E a minor, effect on LDL resistance to oxidation but neither compound appears to alter forearm vascular responses in vivo.
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McDowell et al. (1994) studied this question.
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