Effect of Low Dose Atorvastatin Therapy on Baroreflex Sensitivity in Hypertensives.

Abstract

Impaired baroreflex function is associated with a shift in autonomic balance towards sympathetic dominance, which may play important role in the development of arterial hypertension and consequent target organ damage. To determine the effect of treatment on the cardiovascular autonomic modulation expressed by baroreflex sensitivity (BRS) in hypertensives. Atotal of one hundred fourteen hypertensive patients (58 male/56 female, 65±13years of age, BMI 30±3.4kg/m(2)) were enrolled. Control group of 20 subjects with normal blood pressure (BP) (ten male/ten female, 59±8years of age, body mass index 28.3±2.5kg/m(2)) without any treatment was also studied. BRS and BRSf were determined by the sequence and spectral method: a 5-min on-invasive beat-to-beat recording of blood pressure and R-R interval with use of Collin CBM-7000 monitor, controlled breathing at a frequency of 0.1Hz. Significant negative correlation between spontaneous BRS and BP was present in hypertensives (r=-0.52, p<0.001). All cohort of hypertensive patients had significantly lower BRS than subjects with normal blood pressure (p<0.05). The greatest decline in BRS values was in hypertensive patients with metabolic syndrome, who had BRS values <5ms/mmHg. Hypertensives with hypercholesterolaemia on low dose statin therapy (atrovastatin 20mg) had higher BRS/BRSf values than statin free patients (p<0.05). Only BRSf not BRS was significantly increased in hypertensives with beta-blockers. An inverse correlation between blood pressure and BRS is present in hypertensives. BRS and BRSf is higher in low dose statin-treated patients with essential hypertension.