Lack of effect of pravastatin on cerebral blood flow or parenchymal volume loss in elderly at risk for vascular disease

• Published in: Stroke (1970) 2005-08, Vol.36 (8), p.1633-1636
• Main Authors: TEN DAM, V. Hester, BOX, Frieke M. A, DE CRAEN, Anton J. M, VAN DEN HEUVEL, Dominique M. J, BOLLEN, Edward L. E. M, MURRAY, Heather M, VAN BUCHEM, Mark A, WESTENDORP, Rudi G. J, JAN BLAUW, Gerard
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Biological and medical sciences; Blood Circulation Time; Blood Flow Velocity; Blood Pressure; Brain - drug effects; Brain - metabolism; Brain - pathology; Carotid Arteries - pathology; Cerebrovascular Circulation; Cholesterol - metabolism; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Male; Medical sciences; Nervous system; Nervous system (semeiology, syndromes); Neurology; Pravastatin - therapeutic use; Prospective Studies; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Software; Time Factors; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.0000173162.88600.29

Ageing is associated with a decline in cerebral blood flow. Animal studies have shown that cholesterol-lowering therapy with statins might preserve cerebral blood flow (CBF). We examined the effect of 40 mg pravastatin on the decline in CBF and brain volume in a subset of elderly subjects participating in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) trial. Randomization was not stratified according to whether or not subjects participated in the MRI substudy. In 391 men (n=226) and women (n=165) aged 70 to 82 years (mean+/-SD, 75+/-3.2), we measured total CBF (in mL/min) at baseline and after a mean+/-SD follow-up of 33+/-1.4 months with a gradient-echo phase-contrast MRI technique. Total CBF was defined as the summed flows in both internal carotid and vertebral arteries. Parenchymal volume (whole brain) was segmented with the use of in-house-developed semiautomatic software. Total CBF significantly declined in the placebo-allocated group, from 521+/-83 to 504+/-92 mL/min (P=0.0036) and in the pravastatin-allocated group from 520+/-94 to 506+/-92 mL/min (P=0.018). This decline was not significantly different between treatment groups (P=0.56). There was also a significant reduction in brain volume over time (P