Diastolic function parameters are improved by the addition of simvastatin to enalapril-based treatment in hypertensive individuals
Beck ALS et al. – The addition of simvastatin to enalapril in hypertensive patients with average cholesterol levels improves parameters of diastolic function independently of changes in blood pressure or cholesterol.Methods
- Hypertensive patients with DD and LDL–cholesterol <160mg/dL underwent a run–in phase to achieve a systolic blood pressure (SBP) <135mmHg and diastolic blood pressure (DBP) <85mmHg with enalapril.
- Hydrochlorothiazide was added when need to achieve blood pressure control.
- Four weeks after reaching the optimum anti–hypertensive regimen patients were randomized to receive 80mg simvastatin (n=27) or placebo (n=28) for a period of 20 weeks.
- Echocardiograms were performed before and after treatment with measurement of maximum left atrial volume (LAV), conventional and tissue Doppler velocities in early diastole (E, e’) and late diastole (A, a’).
- After 20 weeks, the simvastatin group presented reduction in SBP (–4±2mmHg, p=0.02), increase in E/A ratio (1.0±0.05 to 1.2±0.06, p=0.03) and decrease of LAV indexed to body surface area (24.5±0.9 to 21.1±0.8ml/m2, p=0.048), as compared with placebo arm.
- No change in systolic function and no correlation between the E/A ratio, LAV and changes in blood pressure or lipid profile were observed.