Effect of Simvastatin on Endothelial Function Parameters in Patients with Hypertension and Ischemic Heart Disease

Background. Dysfunctions in the vascular endothelium precede the development of atherosclerosis in patients with arterial hypertension. Prevention of endothelial damage may potentially delay the appearance of atherosclerotic plaques in blood vessels. Objectives. The objective of the study was to evaluate changes in endothelial function based on serum nitric oxide (NO) level and serum von Willebrand factor activity during an 8-week simvastatin treatment. Material and Methods. The study population consisted of 31 patients aged 40-80 years (mean: 60.8 +/- 11.9 years), 24 females and 7 males, with disturbances in lipid metabolism, primary arterial hypertension, and ischemic heart disease, not previously treated with hypolipidemic agents. The patients were divided into two groups: group A (16 patients with hyperlipidemia and mild/moderate arterial hypertension) and group B (15 patients with hyperlipidemia and mild/moderate arterial hypertension and second class ischemic heart disease). The control group comprised 10 healthy age-matched individuals. Blood samples were taken for measurements of serum NO and lipids and plasma vWf. Simvastatin at a dose of 40 mg/day was then administered orally. The biochemical measurements were also performed after 4 and 8 weeks of simvastatin treatment. Results. Serum NO concentration in the control group was significantly higher than in all the patients during visits 0 (baseline) and 1 (p < 0.05). NO concentration was significantly lower in group A than in the control group during visits 0 and 1. In group B it was significantly lower in all three visits. Moreover, a significantly lower serum NO level was found during visit 2 in group B than in group A. Plasma von Willebrand factor level in the controls was not significantly different from that of the patients during all visits. At baseline, patient serum NO concentration correlated with total cholesterol level, cholesterol LDL, cholesterol HDL, and triglycerides. During visit 2 it correlated with HDL cholesterol level and von Willebrand factor level. Conclusions. Simvastatin treatment significantly improves some parameters of endothelial function in patients with dyslipidemia and arterial hypertension (Adv Clin Exp Med 2010, 19, 2, 195-201).