Study on the Effect of Simvastatin on Left Ventricular Mass and Endothelial Function and the Relationship between Their Changes in the Patients with Essential Hypertension

摘要

Objective: To study the effect of Simvastatin on the left ventricular mass and endothelial function and to investigate the relationship between their changes in the patients with essential hypertension (EH). Methods: 50 patients with hypertension without severe complication were divided into two groups in a randomized, controlled and single blind trial. Group Ⅰ(n = 25) were given Simvastatin and hydragogue for 12 weeks while Group Ⅱ were given hydragogue during the same time. We detected the left ventricular mass and the brachial artery dilatation induced by reactive hyperemia(DIRH)or nitroglycerin(DING)respectively with ultrasonography in all patients before and after treatment. 25 normal subjects without any treatment were taken as the control. Results: The left ventricular mass index (LVMI)was higher in the two groups of patients [(133.61 +- 31.02)g/m~2; (118.04 +- 39.62)g/m~2] than that in the control (88.79 +- 22.73)g/m~2 before treatment (P< 0.01, 0.0001, respectively) while the blood pressure was higher. The DIRH was lower in the two group's of patients(5.93 +- 2.24)%; (6.54 +- 3.16)% than that in the control(13.09 +- 2.99)%, P < 0.000 1. There was no significantly differences in age, serum concentrations of total cholesterol, triglyceride, sugar, blood pressure or the DING between two groups of patients and the control (P > 0.05). And there was no significant difference in the all variables between group Ⅰ and group Ⅱ before treatment. After treatment the LVMI decreased [(133.61 +-31.02)g/m~2 VS(91.07 +- 16.01)g/m~2,P<0.01] and the DTRH increased[(5.93 +- 2.24)% VS(13.53 +- 2.38)%, P<0.01] in the patients of group Ⅰ while there was no significant change in LVMI and DIRH in the patients of group Ⅱ. The blood pressure in the two groups of patients was decreased to the normal. Compared with group Ⅱ. the changes of LVMI and DIRH was higher in patients of group Ⅰ though the serum concentrations of total cholesterol, triglyceride or sugar were not significantly different. No significant change in serum concentrations oftotal cholesterol, triglyceride or sugar was found during treatment in the two groups of patients. Analysis showed that the LVMI correlated with DIRH and the change of LVMI correlated better with the change of DIRH (r = -0.56; 0.69, P<0.000 1, respectly). Conclusions: The increase of left ventricular mass was related with endothelial dysfunction in essential hypertension. Being independent of the changes of serum concentrations of total cholesterol, triglyceride or sugar and blood pressure, Simvastatin could inhibit the increase of left ventricular mass and improve endothelial function.