Efeito da sinvastatina sobre a disfunção diastolica isolada em pacientes com hipertensão arterial sistemica sem hipertrofia cardiaca e sem doença arterial coronariana

Abstract

Background: Therapy with statins was suggested to improve survival on heart failure with preserved systolic function. This benefit was attributed probably to their pleiotropic effects on co-morbidities like coronary heart disease or left ventricular hypertrophy.Aims: evaluate the impact of the treatment with simvastatin on echocardiografic parameters of diastolic function in hypertensive patients without coronary heart disease or left ventricular hypertrophy.Patients and methods: This is a randomized, placebo-controlled, double-blind study. We studied 30 normocholesterolemic hypertensive patients ≤ 50 years without evidence of left ventricular hypertrophy or coronary artery disease assessed under rest and stress echocardiography. The patients have been randomized for placebo or simvastatin (80mg) and reevaluated after 6 months. Results:The baseline characteristics were similar between groups. After six months of treatment, 67% of the patients of simvastatin group presented normalization of diastolic function against 33% in the placebo group (p<0.05). All subjects in simvastatin group who not presented normalization of the diastolic function have increased on systolic and diastolic blood pressure after 6 months (p<0.05 for both). Conclusion:This study demonstrates that a 6 months therapy with simvastatin 80mg/d in asymptomatics hypertensive subjects with diastolic dysfunction had a higher rate of normalization of diastolic function than placebo. The increased of blood pressure observed in some subjects in the simvastatin group appearentelly abolished this benefit.