Banca de DEFESA: GABRIEL SALERNO COSTA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : GABRIEL SALERNO COSTA
DATE: 31/08/2022
TIME: 08:00
LOCAL: meet.google.com/rda-ktpk-nmy
TITLE:

EFFECT OF ATORVASTATIN ON BLOOD PRESSURE AND ITS AUTONOMIC MODULATION IN HUMANS AND RODENTS: A SYSTEMATIC REVIEW WITH META-ANALYSIS

KEY WORDS:

Atorvastatin. Autonomic modulation. Blood pressure. Heart rate variability.

PAGES: 130
BIG AREA: Ciências Biológicas
AREA: Bioquímica
SUMMARY:

Atorvastatin is a drug commonly used to reduce cholesterol synthesis and treat hypercholesterolemia by inhibiting 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase. Recently, studies have shown that statins, in addition to their lipid-lowering action, potentially affect the autonomic nervous system, prevent or improve cardiac dysfunction by inhibiting oxidative stress and improving endothelial function. Considering the inconsistencies in the current literature on the effect of atorvastatin on blood pressure (BP) in humans and rodents, we performed a systematic review and meta-analyses on this tissue. This study aimed to evaluate the effect of atorvastatin on BP and its autonomic modulation, as well as to clarify the relationship between changes in serum cholesterol and these effects. Through a search the EMBASE, PubMed and Web of Science databases, 1,412 articles were identified, from which 31 randomized clinical trials and 44 pre-clinical studies were selected. Populations from randomized clinical trial were stratified according to baseline BP and lipid levels and their methodological quality was assessed using the Jadad scale for clinical trials, while the quality of preclinical studies was assessed using Syrcle. We performed meta-analyses of the effect of atorvastatin on systolic (SBP), diastolic and mean blood pressure, heart rate, heart rate variability, and baroreflex. Independent statistical analyzes were performed for each parameter of the clinical and preclinical studies considering all included articles and/or each stratification. Atorvastatin reduces SBP in the overall population, in hypertensive and hyperlipidemic, and in normotensive and hyperlipidemic individuals in randomized parallel studies, but does not affect SBP in normotensive and normolipidemic individuals. Although an effect of atorvastatin was detected in hyperlipidemic individuals, the meta-regression coefficient for the association of LDL reduction with SBP reduction in the overall population demonstrated that SBP reduction is not dependente on the changes in plasma LDL-cholesterol. A meta-analysis of preclinical reports demonstrated that SBP was reduced in hypertensive and normolipidemic rats treated with atorvastatin [eg, spontaneously hypertensive rats (SHR)], but not in normotensive and normolipidemic rats (controls). In summary, the present meta-analysis indicates that atorvastatin lowers BP by vascular mechanisms independent of LDL-cholesterol levels. Additional studies are needed to estimate the involvement of the autonomic nervous system in the BP-lowering effect of atorvastatin.

BANKING MEMBERS:
Presidente - 1692875 - VALERIA ERNESTANIA CHAVES
Externa ao Programa - 2028750 - CAROLINE PEREIRA DOMINGUETI
Externo à Instituição - DANIEL PENTEADO MARTINS DIAS - CUBM