Siński Maciej, Lewandowski Jacek, Ciarka Agnieszka, Bidiuk Joanna, Abramczyk Piotr, Dobosiewicz Anna, Gaciong Zbigniew
Warszawski Uniwersytet Medyczny, Banacha 1a, 02-097 Warszawa, Poland.
Kardiol Pol. 2009 Jun;67(6):613-20.
Increased sympathetic activity might be related to pathogenesis of hypertension as well as to end organ damage. Animal studies suggest that statins decrease sympathetic activity and increase baroreceptor reflex sensitivity (BRS).
To examine whether atorvastatin decreases muscle sympathetic nerve activity (MSNA) and BRS in hypercholesterolaemic and hypertensive patients.
Ten patients with essential hypertension and untreated hypercholesterolaemia (aged 43 +/- 12 years) and eight healthy subjects (aged 37 +/- 7 years) were enrolled in the study. In both groups the recordings of microneurography, ECG, blood pressure and BRS were performed twice, before and after 8 weeks during which the patients (but not controls) were treated with atorvastatin.
Compared with controls, the patients had higher MSNA values (36.0 +/- 6.6 vs. 29.8 +/- 3.7 bursts/minute), mean BP levels (145.1 +/- 10 vs. 124.1 +/- 11.1 mmHg) and total cholesterol concentration (252.6 +/- 22.6 vs. 179.8 +/- 20.7 mg/dl) baseline values. Statin therapy resulted in a decrease of total cholesterol (252.6 +/- 22.0 vs. 173.8 +/- 26.2 mg/dl, p < 0.05) and MSNA (36.0 +/- 6.6 vs. 28.6 +/- 4.8 bursts/min, p < 0.05), whereas BRS values were increased (12.6 +/- 5.6 vs. 18.1 +/- 5.9 ms/mmHg, p < 0.05). Post-treatment BRS was inversely related to post-treatment MSNA (r = -0.73, p < 0.05). In the controls there were no changes in MSNA (29.8 +/- 3.7 vs. 28.9 +/- 2.9 bursts/min), BRS (11.9 +/- 5.0 vs. 13.1 +/- 4.8 ms/mmHg), total cholesterol, BP and heart rate between the first and the second measurement.
Atorvastatin reduces MSNA and increases BRS in hypertensive and hypercholesterolaemic patients. Decrease in sympathetic activity may be the result of improvement of baroreceptor function by atorvastatin.
交感神经活动增强可能与高血压的发病机制以及终末器官损害有关。动物研究表明，他汀类药物可降低交感神经活动并提高压力感受器反射敏感性（BRS）。
研究阿托伐他汀是否能降低高胆固醇血症和高血压患者的肌肉交感神经活动（MSNA）及BRS。
本研究纳入了10例原发性高血压且未经治疗的高胆固醇血症患者（年龄43±12岁）和8名健康受试者（年龄37±7岁）。两组均进行了微神经电图、心电图、血压及BRS记录，分别在治疗前及治疗8周后各进行一次，治疗期间患者（而非对照组）接受阿托伐他汀治疗。
与对照组相比，患者的MSNA基线值更高（36.0±6.6对29.8±3.7次/分钟）、平均血压水平更高（145.1±10对124.1±11.1 mmHg）以及总胆固醇浓度更高（252.6±22.6对179.8±20.7 mg/dl）。他汀类药物治疗导致总胆固醇降低（252.6±22.0对173.8±26.2 mg/dl，p<0.05）以及MSNA降低（36.0±6.6对28.6±4.8次/分钟，p<0.05），而BRS值升高（十二点六±5.6对18.±5.9 ms/mmHg，p<0.05）。治疗后BRS与治疗后MSNA呈负相关（r=-0.73，p<0.05）。在对照组中，第一次和第二次测量之间，MSNA（29.8±3.7对28.9±2.9次/分钟）、BRS（11.9±5.0对13.1±4.8 ms/mmHg）、总胆固醇、血压及心率均无变化。
阿托伐他汀可降低高血压和高胆固醇血症患者的MSNA并提高BRS。交感神经活动的降低可能是阿托伐他汀改善压力感受器功能的结果。
