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

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 randmnized, 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 ventricttlar nmss and the brachial artery dilatation induced by reactive hyperemia(DIRH)or nitroglycerin(DING) respectively with ultrasonography in all patients before and after treatmerit.25 normal subjects without any treatment were taken as the control. Resu/ts: The left ventricular ~ index(LVMI)was higher in the two groups of patients[ (133.61 ~ 31.02)g/m2 ; ( 118.04±39.62)g/m^2 ] than that in the control (88.79±22.73)g/m^2 before treatment(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<0.01and 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 |. The blood pressure in the two groups of patients was decreased to the normal. Comimred with group Ⅱ, the changes of LVMI and DIRH was higher in patients of group Ⅰ though the sermn concentrations of total cholesterol, triglyceride or sugar were not significantly diffexent. No significant change in sermn concentrations oftotal cholesterol, tri_glyceride or sugar was found during treatment in the two groups of patients. Analysis showed that the LVMI correlated with DIRH and the clmnge of LVMI correlated better with the change of DIRH (r=-0.56;0.69,P<0.0001,respectly). Conchusions: The in crease of left ventricular mass was related with endothelial dysftmction in essential hypertension. Being independent of the changes of sermn concentrations of total cholesterol, triglyceride or sugar and blood pressure, Sinvastatin could inhibit the increase of left ventricular mass and improve endothelial function.