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Effects of pravastatin on left ventricular mass in patients with hyperlipidemia and essential hypertension
1College of Medicine, Department of Clinical Pharmacy, National Cheng Kung University, Tainan, Taiwan.
Insights
Statin therapy, particularly pravastatin, significantly reduced left ventricular (LV) mass in hypertensive patients with hyperlipidemia. This reduction in LV mass was greater than with other treatments, suggesting an independent effect beyond lipid lowering.
Area of Science:
- Cardiology
- Pharmacology
- Cardiovascular Research
Background:
- Left ventricular (LV) mass predicts cardiovascular events.
- Hyperlipidemia is linked to increased LV mass.
- Statin therapy's effect on LV mass remains unstudied.
Purpose of the Study:
- To investigate the impact of statin therapy on LV mass in hypertensive patients.
- To compare the effects of statins plus antihypertensives versus other treatments on LV mass.
Main Methods:
- Prospective study of 3 matched patient groups (n=20 each) and controls.
- Group 1: Hypertension, hyperlipidemia, treated with pravastatin + antihypertensives.
- Group 2: Hypertension, hyperlipidemia, treated with antihypertensives + diet.
- Group 3: Hypertension, normolipidemia, treated with antihypertensives.
- Echocardiograms assessed LV mass at baseline and after 6 months.
Main Results:
- All hypertensive groups showed decreased LV mass index post-treatment.
- Group 1 (statin use) exhibited the greatest LV mass reduction.
- Statin use and sex were significant predictors of LV mass regression (p=0.005, p=0.01).
- In Group 1, reduced LV mass correlated with increased arterial compliance (r=0.57, p=0.01).
Conclusions:
- Statin therapy may offer additional benefits in reducing LV mass.
- This effect appears independent of lipid-lowering properties.
- Statin addition to antihypertensive therapy warrants consideration for LV mass reduction.
Abstract:
Left ventricular (LV) mass is a powerful predictor for future cardiovascular events. Epidemiologic studies have shown that hyperlipidemia is associated with higher LV mass. The effects of statin therapy for hyperlipidemia on LV mass have not been studied. To determine the effects of statin therapy on LV mass, we prospectively studied 3 groups of age and body surface area-matched patients: group 1 (n = 20), patients with systemic hypertension and hyperlipidemia treated with pravastatin plus anti-hypertensive drugs; group 2 (n = 20), patients with hypertension and hyperlipidemia treated with hypertensive agents and diet control alone; and group 3 (n = 20), hypertensive patients with normolipidemia treated with antihypertensive agents. A group of controls without hypertension or hyperlipidemia was used for comparison. Echocardiograms were recorded at baseline and after 6-month therapy. All hypertensive groups showed significant decreases in LV mass index after treatment. Group 1 had the greatest decrease in LV mass and it was significantly higher than in groups 2 and 3. Multivariate analysis revealed that regression of LV mass was significantly correlated only with the use of statins and sex (p = 0.005 and 0.01, respectively, R(2) = 0.47). Linear regression analysis in group 1 showed a significant correlation between changes in arterial compliance and LV mass regression (r = 0.57, p = 0.01). Thus, the addition of a statin may have an additional effect on reducing LV mass, independent of lipid-lowering effects.
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