Differential Effects Of Statins On Vascular Function In Essential Hypertensive Patients With Aging

Objectives:The study was to evaluate the effect of statins on vasodilatations of brachial andanterior tibial arteries in aging patients with essential hypertension(EH) by examingboth the endothelium-dependent (EDD) and endothelium-independent (EID)vasodilatations.Methods:847outpatients with EH and215normotensive subjects were enrolled from ourhospital between August2000and May2014. The dilatations of brachial and anteriortibial arteries induced by reactive hyperemia or nitroglycerin were examined byhigh-resolution vascular ultrasound, which determined the EDD and EID respectively.Part of the patients were followed-up. The EDD and EID of brachial artery (BA) andtibial artery(TA) were measured at baseline and after follow-up periods.Results:1. Of847EH patients,479were male,.368were female, mean age65.6±11.2,.Of215normotensive patients103were male,112were female, mean age57±11.3.150EHpatients and11normotensive subjects were followed-up. Periods of following-upranged from2to164months.2. There was a remarkable decrease in EDDs and EIDs in EH patients during theprocess of ageing [BAEDD（:under40）11.03±6.12%vs (40-49)10.54±6.2%vs(50-59)9.73±5.77%vs(60-69)8.62±5.85%vs(70-79)8.57±5.4%vs (ove80)8.22±5.01%P<0.01].3. There was a trend of increase in TAEDD and TAEID in EH patients during6months’ antihypertensive treatment （TAEDD6.09±5.87%vs10.45±6.73%,P<0.05）（TAEID9.39±7.03%vs11.14±6.04%，P<0.05）.BAEDD（7.52±4.68%vs9.78±4.47%, P<0.01） and TAEDD (6.09±5.87%vs9.97±4.70%, P<0.01）wereincreased during the next6months.4. TAEDD（5.64±5.82%vs10.72±4.52%，P<0.01）was increased in EH patients over65years’old after statin therapy for more than1year. 5．EDDs and EIDs were not augmented in EH patients under65on statin therapy.Conclusion:1.During aging process, EDDs and EIDs declined remarkably among EH patients.2.Within one year’s hypertensive treatment, the vasodilations were improved amongEH patients over65years old.3. EDDs in both brachial artery and tibal artery were ameliorated in EH patients (over65-years-old) on statin. TAEDD was significantly increased after1year,suggestingthat EDD of tibial artery may be more sensitive.4. However, there is no trend of augment in EDDs or EIDs in EH patients under65onstatin.