高血压不同并发症患者血浆内皮素变化及辛伐他汀干预对其影响

Objective To observe the association between plasma endothelin (ET) concentration and blood pressure level in essential hypertensive (EH) patients with or without complications and possible impact of statins on ET concentration. Methods From Sep 2007 to Mar 2009, 149 patients with EH were analyzed [44 EH, 40 EH complicated by left ventricular hypertrophy (EH-LVH), 36 EH complicated by atrial fibrillation (EH-AF), and 29 EH complicated by lacunar infarction (EH-LI)], 30 healthy persons were selected as controls. EH patients were randomly divided into routine treatment group (calcium antagonists, ACEI, diuretics, β-receptor blocker for 8 weeks) and simvastatin intervention group (routine treatment + simvastatin 40 mg/d for 8 weeks), plasma ET concentrations before and after drug intervention were measured. Results (1) ET concentration was higher in EH group than that in control group[ (71.42 ±6.62) pg/ml vs. (45.52±8.28) pg/ml, P < 0.01 ]. ET concentration was higher in EH-LVH group, EH-AF group and EH-LI group than that in EH group [ (97.67±10.53) pg/ml, (102.15±12.96 ) pg/ml, (103.49±9.91) pg/ml vs. (71.42±6.62) pg/ml, P<0.01]. The degrees of elevated blood pressure was positively correlated with ET concentrations(all P < 0.001). (2) The left atrial diameters of EH-AF group were positively correlated with ET concentration (r = 0.684, P < 0.001). The left ventricular mass index of EH-LVH group were positively correlated with ET concentration (r = 0.545, P < 0.001). (3) The percentages of class 3 hypertension in EH-LVH group, EH-AF group and EH-LI group were higher than that in EH group (57.5%, 50.0%, 62.1% vs. 25,0% ,all P <0.05). (4) Blood pressure in class 3 hypertension patient treated with simvastatin decreased more significantly than that in routine treatment group(P <0.05). (5)ET concentration of class 2 hypertension patient treated with simvastatin decreased significantly than that in routine treatment group(P < 0.05). ET concentrations of class 3 hypertension patient treated with simvastatin and routine treatment patient decreased significantly after treatment (P < 0.05), and the former was lower (P < 0.05). Conclusion The level of ET were positively correlated with the severity of EH. Simvastatin could decrease the ET levels of patients with EH and blood pressure levels of patients with class 3 hypertension. It suggested that therapeutic alliance of antihypertensive drugs and statins could be benefit to patients with EH.

Plasma endothelin level in hypertensive patients receiving standard anti-hypertensive therapy with or without statins