Abstract
Perpose: Inflammatory markers, such as C-reactive protein (CRP), tumor necrosis factor-alfa (TNF-alfa) have been shown to predict future cardiovascular events. Statins anti-inflammatory properties have been established. The aim of the study was to investigate the effect of atorvastatin under prolonged combination treatment on markers of inflammation among hypertensives with metabolic syndrome (MS). Methods: In total, 25 patients with arterial hypertension (AH) and with MS by ATP III criteria (2001) and preserved left ventricular (LV) ejection fraction (EF > 50%), aged 55±7 years, were examined. All patients were treated enalapril 10–20 mg/d or irbesartan 150 mg/d plus indapamid 2.5–5 mg/d and atorvastatin 10 mg/d. The control group consisted of 10 healthy people. Methods included daily blood pressure (BP) monitoring, measurements of plasma glucose, insulin (EI), CRP, TNF-alfa levels with ELISA kits and oral glucose-tolerant tests (OGTT) which were performed at baseline and 8 weeks after addition atorvastatin. Results: The basal mean BP was equal to 143±14 mmHg. Plasma glucose remained in the normal range during OGTT (p>0.05). In 15 (60%) patients with normal plasma EI levels (group 1) the basal CRP and TNF-alfa levels were equal to 2.12±0.61 mg/l and 7.75±0.86 pg/ml vs. 0.45±0.15 mg/l and 5.94±0.75 pg/ml in the control (p < 0.05) respectively. In 10 (40%) cases (group 2) the plasma EI levels were increased to 46.34±19.88 mcU/ml after OGTT vs. 13.26±3.03 mcU/ml in the control (p < 0.05). In group 2 plasma CRP and TNF-alfa levels were higher and were equal to 3.61±0.60 mg/l and 9.48±1.13 pg/ml respectively vs. the patients group 1 and the control (p < 0.05). The desirable positive changes in clinical manifestation of AH and control of BP were observed in 17 (68%) cases with a tendency to normalise CRP, TNF-alfa levels especially in patients of group 2. Conclusions: Atorvastatin increases the antihypertensive effect of combination treatment and promotes the decrease of inflammation, especially in hypertensives with hyperinsulinemia.
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