Department of Nephrology and Hypertension, University of Erlangen-Nuremberg, Erlangen, Germany.
J Hypertens. 2011 Sep;29(9):1757-64. doi: 10.1097/HJH.0b013e32834a509a.
Patients with arterial hypertension are characterized by impaired endothelial function and increased cardiovascular risk. Statins have been proposed as a potential treatment option in hypertension, even in those with normal low-density lipoprotein (LDL)-cholesterol levels. We tested whether fluvastatin reduces oxidative stress and inflammation, and improves endothelial function in patients with arterial hypertension and normal LDL-cholesterol.
In a cross-over designed, double-blind randomized trial, 26 patients with arterial hypertension and LDL-cholesterol below 160 mg/dl were treated for 2 weeks with either placebo or fluvastatin 80 mg/day. Endothelium-dependent vasodilation (EDV) was assessed as the forearm blood flow (FBF) response to intra-arterial infusion of acetylcholine (ACH, 12 and 48 μg/min), and endothelium-independent vasodilation (EIV) as the FBF response to nitroprusside (3.2 and 12.8 μg/min). Furthermore, we measured reduced to oxidized glutathione (GSH/GSSG) ratio in red blood cells, total antioxidant capacity in plasma (TAC) and high-sensitivity C-reactive protein (hs-CRP) levels.
Fluvastatin lowered LDL-cholesterol from 118 ± 16 to 90 ± 25 mg/dl (P < 0.0001), but had no effect on blood pressure, high-density lipoprotein (HDL)-cholesterol or triglycerides. EDV and EIV were unaffected by fluvastatin treatment (e.g. increase of FBF 48 μg/min: 339 ± 285% during placebo versus 268 ± 194% during fluvastatin, n.s.). Finally, GSH/GSSG ratio, TAC and hs-CRP levels were similar between fluvastatin and placebo treatment.
Fluvastatin treatment did not improve endothelial function, oxidative stress or inflammation in patients with arterial hypertension and normal LDL-cholesterol levels. These data argue against the usefulness of statins in patients with arterial hypertension in the absence of hypercholesterolemia or other additional risk factors.
动脉高血压患者的特点是内皮功能受损和心血管风险增加。他汀类药物已被提议作为高血压的潜在治疗选择，即使在低密度脂蛋白（LDL）胆固醇水平正常的患者中也是如此。我们测试了氟伐他汀是否可以降低氧化应激和炎症，并改善动脉高血压和正常 LDL 胆固醇患者的内皮功能。
在一项交叉设计、双盲随机试验中，26 名 LDL 胆固醇低于 160mg/dl 的动脉高血压患者接受安慰剂或氟伐他汀 80mg/天治疗 2 周。通过测量乙酰胆碱（ACH，12 和 48μg/min）的动脉内输注对内前臂血流（FBF）的影响评估内皮依赖性血管舒张（EDV），通过测量硝普盐（3.2 和 12.8μg/min）的动脉内输注对内前臂血流（FBF）的影响评估内皮非依赖性血管舒张（EIV）。此外，我们测量了红细胞中还原型谷胱甘肽（GSH）/氧化型谷胱甘肽（GSSG）的比例、血浆中的总抗氧化能力（TAC）和高敏 C 反应蛋白（hs-CRP）水平。
氟伐他汀使 LDL 胆固醇从 118±16 降至 90±25mg/dl（P<0.0001），但对血压、高密度脂蛋白（HDL）胆固醇或甘油三酯没有影响。氟伐他汀治疗对 EDV 和 EIV 没有影响（例如，FBF 增加 48μg/min：安慰剂时为 339±285%，氟伐他汀时为 268±194%，无统计学差异）。最后，GSH/GSSG 比例、TAC 和 hs-CRP 水平在氟伐他汀和安慰剂治疗之间相似。
氟伐他汀治疗并未改善动脉高血压和正常 LDL 胆固醇水平患者的内皮功能、氧化应激或炎症。这些数据表明，在没有高胆固醇血症或其他额外危险因素的情况下，他汀类药物对动脉高血压患者没有用处。
