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

Content Provider	Springer Nature : BioMed Central
Author	Hornik, Ezra S. Altman-Merino, Anne E. Koefoed, Andrew W. Meyer, Kayla M. Stone, Isabella B. Green, Jessica A. Williams, Gordon H. Adler, Gail K. Williams, Jonathan S.
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). 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. 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. Trial registration ClinicalTrials.gov; NCT02871687 ; First Posted August 18, 2016.
Related Links	https://bmcendocrdisord.biomedcentral.com/counter/pdf/10.1186/s12902-020-00587-4.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	14726823
DOI	10.1186/s12902-020-00587-4
Journal	BMC Endocrine Disorders
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2020-07-14
Access Restriction	Open
Subject Keyword	Endocrinology Metabolic Diseases Diabetes Andrology Aldosterone Statins Cardiovascular health Metabolic health Hypertension Hyperlipidemia Mineralocorticoid Simvastatin Pravastatin
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3.1/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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