Reduction in carotid arterial wall thickness using lovastatin and dietary therapy: a randomized controlled clinical trial

Ann Intern Med. 1996 Mar 15;124(6):548-56. doi: 10.7326/0003-4819-124-6-199603150-00002.


Objective: To assess the effects of lipid-lowering therapy on the progression of early, preintrusive carotid arterial atherosclerosis.

Design: Randomized, double-blind, placebo-controlled, serial carotid arterial imaging trial.

Setting: University Atherosclerosis Research Unit.

Patients: 188 patients from the Monitored Atherosclerosis Regression Study who were 37 to 67 years of age and had angiographically defined coronary artery disease.

Intervention: Cholesterol-lowering diet plus placebo or lovastatin, 80 mg/d.

Measurements: High-resolution B-mode ultrasonographic quantification of the combined thickness of the distal common carotid arterial far wall intima-media complex (carotid arterial intima-media thickness) at baseline and every 6 months for as long as 4 years.

Results: The annual rate of change in carotid arterial intima-media thickness differed significantly between the lovastatin group and the placebo group at 2 and 4 years (P < 0.001).

Conclusion: Lipid-lowering therapy reverses the progression of early, preintrusive atherosclerosis of the carotid artery. Both cholesterol-rich and triglyceride-rich lipoproteins correlate with the progression of early, preintrusive atherosclerosis of the carotid artery. These findings, together with earlier reports of the effects of lovastatin therapy on the progression of atherosclerosis of the coronary arteries, indicate that carotid arterial far wall intima-media thickness is a useful end point for anti-atherosclerosis trials.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Anticholesteremic Agents / therapeutic use*
  • Arteriosclerosis / blood
  • Arteriosclerosis / diagnostic imaging
  • Arteriosclerosis / diet therapy
  • Arteriosclerosis / drug therapy*
  • Carotid Arteries / drug effects*
  • Carotid Artery Diseases / blood
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / diet therapy
  • Carotid Artery Diseases / drug therapy*
  • Double-Blind Method
  • Female
  • Humans
  • Lipids / blood
  • Lovastatin / therapeutic use*
  • Male
  • Middle Aged
  • Placebos
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects
  • Tunica Intima / drug effects
  • Ultrasonography


  • Anticholesteremic Agents
  • Lipids
  • Placebos
  • Lovastatin