Pravastatin reduces carotid intima-media thickness progression in an asymptomatic hypercholesterolemic Mediterranean population: The Carotid Atherosclerosis Italian Ultrasound Study

Purpose The Carotid Atherosclerosis Italian Ultrasound Study (CAIUS) was performed to test the effects of lipid lowering on the progression of carotid intima-media thickness (IMT) in 305 asymptomatic patients from a Mediterranean country. Patients and methods Eligibility included hypercholesterolemia (baseline means: low-density lipoprotein [LDL] = 4.68 mmol/L. high-density lipoprotein [HDL] = 1.37 mmol/L), and at least one 1.3 Results Five serious cardiovascular events (1 fatal myocardial infarction), and 7 drop-outs for cancer were registered. In the pravastatin group, LDL decreased −0.22 after 3 months versus −0.01 in the placebo group, and remained substantially unchanged afterward (−0.23 versus +0.01 at 36 months, respectively). Progression of the MMaxIMT was 0.009 ± 0.0027 versus −0.0043 ± 0.0028 mm/year ( ± SE, P Conclusions Pravastatin stops the progression of carotid IMT in asymptomatic, moderately hypercholesterolemic men and women. This finding extends the beneficial effects of cholesterol lowering to the primary prevention of atherosclerosis in a population with relatively low cardiovascular event rates, and suggests that this benefit is mediated by specific morphological effects on early stages of plaque development.