Effects Of Statins On Vascular Function In Essential Hypertensives With Metabolic Syndrome

Objective: To investigate the effects of statins on vascular function in essential hypertensives with metabolic syndrome.Methods: 1153 essential hypertensives and 316 normotensives were enrolled from outpatient and inpatient care of the First Affiliated Hospital of Fujian Medical University between Aug.2000 and Apr.2016.All of the subjects were divided into three groups according to their clinical characteristics: essential hypertensive with metabolic syndrome group(MS group,n=542),essential hypertensive without metabolic syndrome group(NMS group,n=611)and normotensive group(NT group,n=316).As target arteries,brachial and anterior tibial arteries were examined to assess the vascular dilation by high-resolution vascular ultrasound.The change of vessel diameter in target arteries induced by reactive hyperemia and nitroglycerin was used to evaluate endothelium-dependent dilatation(EDD)and endothelium-independent dilatation(EID)respectively.All the subjects were grouped according to their age(six 10-year groups)among the MS,NMS and NT group to observe the change of vascular function with aging.The related factors of vascular function in all subjects were explored.186 essential hypertensives with metabolic syndrome and 135 essential hypertensives without metabolic syndrome were followed up,those subjects were divided into middle-aged(age<65 years old)and elderly group(age?65 years old).The vascular function of target arteries was determined among MS group and NMS group before and after statin treatment in different follow-up periods.Moreover,41 normotensives were also followed up to serve as controls.Results: 1.A total of 1469 subjects,including 542 essential hypertensives with metabolic syndrome,611 essential hypertensives without metabolic syndrome and 316 normotensives,were enrolled.362 subjects were followed up,of which 186 patients were essential hypertensives with metabolic syndrome,135 patients were essential hypertensives without metabolic syndrome and 41 subjects were normotensives.In MS group,296 person-times were followed up,and the mean follow-up period was 26.23±22.30 months.In NMS group,231 person-times were followed up,and the mean follow-up period was 33.64±33.54 months.In NT group,63 person-times were followed up,and the mean follow-up period was 27.15±17.65 months.2.With aging,there was a remarkable decline in vascular function of normotensives,essential hypertensives with and without metabolic syndrome.Stepwise multiple regression analysis revealed that age was a major determing factor for EDD and EID in brachial and anterior tibial arteries.3.TAEDD was increased significantly in essential hypertensives with metabolic syndrome under 65 years old after 1-2 years' statin treatment(n=43)[baseline(7.45±3.45)% VS after 1-2 years' treatment(10.24±3.46)%,P<0.05].And TAEDD was increased significantly after 2-4 years' statin treatment(n=24)[baseline(7.45±3.45)% VS after 2-4 years' treatment(9.69±4.45)%,P<0.05].4.In essential hypertensives without metabolic syndrome over 65 years old,a significant increase in TAEDD was noted after 1-2 years' statin treatment [baseline(7.03±5.74%)VS after 1-2 years' treatment(10.36±4.48)%,P<0.05].Conclusion: 1.Age was a major determing factor for vascular dilatation.The decline of vascular dilatation was associated with aging among normotensives,essential hypertensives with and without metabolic syndrome.2.There was an improvement of TAEDD in essential hypertensive patients with metabolic syndrome under 65 years old after 1 years' statin therapy.3.After 1 years' statin treatment,TAEDD could be ameliorated in essential hypertensives without metabolic syndrome over 65 years old.