To examine the additional to antihypertensive treatment effect of rosuvastatin on a left ventricular mass index (LVMI) and parameters of low - grade systemic inflammation at high risk essential hypertensive patients.Design and method:
43 statin naïve essential hypertensive patients (EH pts) were included in the study. All EH pts treats with fixed dose combination of valsartan 160 mg and amlodipine 5 mg. They were randomized into two groups: 23 pts on rosuvastatin 10 mg a day and 20 without any statin therapy. Baseline (after 1 week of wash-out of previous antihypertensive treatment) and final examination (after 6-month treatment) concludes ABPM, cardiac ultrasound with estimation of LVMI according to the American Society of Echocardiography and the European Association of Cardiovascular Imaging (2015), the plasma concentration of C-reactive protein (CRP), interleukin - 6 (IL-6) and tumor-necrosis factor - α (TNF-α) (by ELISA assay, Bender medsystems, Austria).Results:
The initial levels of blood pressure, parameters of low-grade inflammation and LVMI were comparable. Antihypertensive effect was similar in both groups except for reducing nighttime SBP, it was greater in rosuvastatin group - 14,8% vs 11,7% (p = 0.04). It associated with more significant (p = 0.04) reduction of LVMI under rosuvastatin treatment - by 10% (from 123.6 ± 5.4 to 111.3 ± 4.9 g/m2; p = 0.002) vs 6% in comparing group (from 121.8 ± 6.4 to 114.4 ± 6.2 g/m2; p = 0.02). The lowering of low-grade inflammation markers were more pronounced at statin group also – CRP by 29.4% vs 11.1% (p = 0.01), IL-6 by 25.4% vs 10.3% (p = 0.02) and TNF-α by 10.9 % vs 4.9% (p = 0.04) (table). There was the positive correlation between the dynamic of LVMI, on one hand, and changes of nighttime SBP (r = 0.41; p = 0.03), TNF-α (r = 0.56; p = 0.01) and IL-6 (r = 0.43; p = 0.02), on the other hand.Results:
The dynamics of blood pressure and proinflammatory parameters under antihypertensive and rosuvastatin treatmentConclusions:
Adding of rosuvastatin to antihypertensive treatment resulted in an additional decrease of LVMI. It may be the result of the better night-time BP control in rosuvastatin group. The regress of left ventricular hypertrophy also associated with diminished of low-grade inflammation which is greater under rosuvastatin treatment.