The Influence Of Simvastatin On Blood Pressure Variability Of Hypertension

Objective: With the development of society and improvement of people’sliving standards, the trend of the morbidity and mortality of hypertension isupward year by year。Studies have shown that the blood pressure variability(blood pressure variability, BPV) of hypertensive patients is closely associatedwith target organ damage.The greater the BPV in patients, the more damageto the target organs. These target organs include heart, brain, kidney andblood vessels. However, the largest effect on the heart and brain increasesthe morbidity and mortality of stroke and coronary heart disease. Bloodpressure variability predicting the occurrence and development of stroke,coronary heart disease, kidney damage and artery plays an important role onetiology and prognosis. Therefore, disease been early detection andintervention treatment is particularly important. Precisely because of this,statins as the advent of primary and secondary prevention of cardiovasculardisease has significant milestone significance. Interestingly, the NO-mediatedvasodilator function of the endothelium, in response to reactive hyperaemia,has been widely studied as a test of endothelial integrity in patients withhypertension.Even though, ED is thought to be a consequence of hypertension,the existing evidence suggest that this abnormality may predispose to thedevelopment of hypertension.Almost essential hypertension is accompaniedby Impaired endothelial function which can reflect severity of hyperte-nsion.Statins improve endothelial function,anti-oxidation, anti-inflam-matory,thrombolysis and lower blood pressure through the complexity of multiplemechanisms. But it is seldom reported that BPV of hypertension changed bysimvastatin.Methods: The study was conducted in60outpatients with essentialhepertension associated with diabetes.They were patients of new diagnosed of hepertension including26male patients and34female patients, not regulartreatment and discontinuation of anti-hypertensive drugs used five half life.Hypertension diagnosis standard basis is according to2010China Hyperten-sion Prevention Guide. All subjects were strictly in accordance with theinclusion criteria. and exclusion criteria.60subjects were randomized into twogroups.The subjects in group A take Losartan Potassium50mg/d and thesubjects in group B take Losartan Potassium50mg/d combine withsimvastatin20mg/d (Group B) for8weeks. Ambulatory blood pressure andserum NO were measured at week0and week8. Ambulatory blood pressurewas measured by non-invasive and portable24hours ABPM device.Short-term BP variability was assessed as the standard deviation (SD), whichcomprised of mean ambulatory BP value was the Coefficient of Variation.Serum NO level was tested to observe the effect on vascular endothelialfunction.Statistical Analysis:All the data conforming to the normality werepresented as mean±standard deviation.Patients were randomly divided intotwo groups, one group for single application of potassium chloride sandjotham, another group for taking potassium chloride sand jotham andsimvastatin.The data conforming to the normality between two groups werecompared through t test. Using multiple linear regression analysis analyse theinfluence factors of BPV and the corresponding influence degree. P <0.05had significant statistical significance. In this study,SPSS13.0statisticalsoftware was used to analyses statistics.Results:1Compared with group A,mean SBP, TG, gender, age, BMI,TC,LVMIand FBG(fasting blood-glucose) in group B had no difference.2Compared with the baseline (week0),24hSSD，dSSD，nSSD，24hDSD,24hDCV,dDSD,nDCV and LVMI significantly decreased in group A,and serum NO level was significantly higher (P<0.05). However,24hSCV，dSCV，nSCV，dDCV and nDSD had no difference before and after thetreatment (P>0.05). 3Compared with the baseline (week0),24hSSD,24hSCV,nSCV，24hDSD，24hDCV，nDSD，LVMI，TC and LDL-Csignificantly decreasedin group B，and serum NO level was significantly higher (P<0.05).However,dSSD，dSCV，nSSD，dDSD，dDCV and nDCV had no difference before andafter the treatment (P>0.05).4Compared with group A (week8),24hSSD，24hSCV，24hDSD andLVMI significantly decreased and dSSD， dSCV， nDCV and nDSDsignificantly increased in group B,and plasma NO level was significantlyhigher (P<0.05).However,24hSCV、dSCV、nSCV、dDCV、nDSD had nodifference before and after the treatment (P>0.05).5BPV correlated with LVMI,the plasma NO level,TC and LDL-C（P<0.05).Conclusion:Potassium chloride sand jotham reduce blood pressurevariability and target organ damage. Simvastatin not only lower totalcholesterol and low-density lipoprotein (LDL), but also reduce blood pressurevariability and target organ damage. Blood pressure variability is related withEndothelial function、LDL-C、TC and heart target-organ damage..