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Purpose of simvastatin treatment of patients with essential hypertension, cardiac hypertrophy and left ventricular systolic function and diastolic function. Experimental methods to choose from August 2005 to September 2007 in our hospital inpatient and outpatient meet the 1999 WHO / ISH diagnostic criteria, untreated patients with essential hypertension. Filter in strict accordance with the inclusion criteria and exclusion criteria: diagnosis of patients with essential hypertension, antihypertensive drugs taking telmisartan-based follow-up once every two weeks, blood pressure, not standard, followed by the addition of calcium antagonists, beta-blockers, thiazide diuretics (both the conventional effective dose); heart dysfunction patients plus digoxigenin 0.125mg / 1 / d. Until the clinician referral blood pressure to normal range, SBP <140mmHg and DBP <90mmHg. Blood pressure standards for the first time ultrasound echocardiography, myocardial hypertrophy again history verification and coronary angiography or coronary CTA, angiography or ultrasound of the renal artery, renal and adrenal B ultrasound, chest X-ray as well as blood, urine biochemical check, eliminate all disease known to cause cardiac hypertrophy or affect their condition. Selected cases 42 people, including 33 males and 17 females, and signed informed consent randomized single blind after the book is divided into two groups: a control group (T), given telmisartan-based antihypertensive treatment; one group is the treatment group (TS), telmisartan based antihypertensive treatment with simvastatin. Observed after 1 year of treatment, blood pressure, blood lipids, and echocardiography in detecting cardiac hypertrophy, left ventricular systolic and diastolic function. Measurement data are expressed as mean ± standard deviation (x ± s). Group before and after treatment with the paired t test, the groups were compared using analysis of variance. Drug use between the two groups, expressed as a percentage, between the two groups with the χ2 test. Using the SPSS13.0 software processing data, p lt; 0.05 for difference. 1, hypertension and cardiac hypertrophy in the general situation of the patient during treatment, T group lead to severe aortic regurgitation and removed one cases of infective endocarditis, effective 18 cases, including 10 males and 8 females. TS group active cases of 23 cases, including 17 males and 6 females. Throughout the treatment process is not stopped due to the occurrence of adverse drug reactions and treatment of cases. 1.1 237 cases of hypertension and cardiac hypertrophy in patients with the coexistence of other diseases situation from August 2005 to September 2007, our hospital and outpatient untreated hypertensive patients, After antihypertensive treatment standards, echocardiography with myocardial hypertrophy The patient 237 cases. Exclusion criteria, 195 patients excluded, accounting for 82.28%, which exclude 136 cases of coronary heart disease, accounting for 69.74% of the excluded cases (accounting for the merger in patients with cardiac hypertrophy 57.38%). Excluding one cases followed up. Eventually meet the standards of pure primary hypertension and myocardial hypertrophy in 41 patients, accounting for 17.30% of all hypertension and left ventricular hypertrophy in patients. 1.2 41 patients before treatment blood pressure was selected cases before treatment, systolic blood pressure (SBP) the 189.44 ± 20.10mmHg, diastolic blood pressure (DBP) 100.71 ± 16.51mmHg, higher systolic blood pressure levels. The changes in value of 1.3. Lipid changes in the two groups of patients before and after treatment compared with the control group (T), simvastatin group (TS) of the patient's total cholesterol (TC) and low density lipoprotein (LDL) before and after treatment and changes The percentage increased significantly (p lt; 0.01). That simvastatin significantly reduced TC, LDL. 2 antihypertensive effect 2.1.1. Antihypertensive effect of all eligible cases (41 cases) systolic blood pressure before treatment was 189.44 ± 20.10mmHg, the diastolic pressure 100.71 ± 16.51mmHg, prompts selected patients with high blood pressure levels. Systolic blood pressure after treatment 133.07 ± 13.84mmHg, diastolic blood pressure the 79.07 ± 8.00mmHg, decreased significantly (p <0.01) than before treatment. 2.1.2. To buck the standard in combination with other antihypertensive drugs in separate to use telmisartan buck compliance ratio of 17.07%, 41.46% bivalent proportion of antihypertensive drugs, a triple antihypertensive medications proportion is 41.46%. Combination with other antihypertensive drugs proportion of the most the CCB class (68.29 percent), followed by thiazide diuretics (36.59%) and beta blockers (31.71%). 2.2.1 The control group (T group) systolic blood pressure antihypertensive effect of T group patients before treatment 187.17 ± 20.21mmHg, 99.83 ± 15.95mmHg; diastolic blood pressure after treatment, systolic blood pressure the 139.22 ± 16.34mmHg, diastolic blood 79.06 ± 8.22mmHg than before treatment decreased significantly (p <0.01). 2.2.2 the control group (T group) to be used alone or in combination with other antihypertensive drugs telmisartan buck ratio is 22.22% compliance, antihypertensive drugs bivalent ratio is 33.33% and 44.44%, triple the proportion of antihypertensive drugs . Combination with other antihypertensive drugs proportion is the CCB class (66.67%), followed by thiazide diuretics (38.89%) and beta blockers (16.67%). 2.3.1. Treatment group (TS) antihypertensive effect of TS patients before treatment, systolic blood pressure, 191.22 ± 20.29mmHg, diastolic blood pressure, 101.39 ± 17.26mmHg; systolic blood pressure after treatment 128.26 ± 9.33mmHg, diastolic blood pressure 79.09 ± 8.02mmHg than before treatment decreased significantly (p <0.01). The 2.3.2. Treatment group (TS) to be used alone or in combination with other antihypertensive drugs telmisartan buck compliance ratio is 4.35%, and the proportion of antihypertensive drugs bivalent is 47.83%, and 47.83%, triple the proportion of antihypertensive drugs . Combination with other antihypertensive drugs proportion is the the CCB class (69.57%), followed by beta-blockers (43.48%) and thiazide diuretics (34.78%). 2.4.1 the control group (T) and treatment group (TS) antihypertensive effect in telmisartan-based antihypertensive treatment plus simvastatin can reduce systolic blood pressure (P lt; 0.05 ). 2.4.2. Combination of the control group (T) and treatment group (TS) compared to the situation of other antihypertensive drugs. To telmisartan to buck the basis of use of other antihypertensive drugs between the T group and the TS group showed no significant difference (p gt; 0.05). Telmisartan (T) on myocardial hypertrophy and left ventricular function 3.1. Telmisartan on myocardial hypertrophy telmisartan after 1 year, patients of the interventricular septum (IVS), left ventricular mass (LVM), left ventricular mass index (LVMI) than before decreased (P lt; 0.05), suggesting that left ventricular hypertrophy reversal; while left ventricular internal diameter (LVDd), left ventricular posterior wall thickness (LVPW) no significant change (p gt ; 0.05). 3.2 telmisartan on left ventricular systolic function before treatment, left ventricular ejection fraction EF 66.83 ± 11.62%; telmisartan 1 year EF65.67 ± 10.63% (p gt; 0.05), left ventricular systolic function did not improve. 3.3 telmisartan on left ventricular diastolic function using telmisartan 1 year, the increase in patients with left atrial (LA) (P lt; 0.05); Although there is an upward trend in the E / A ratio, but not statistically significance (p gt; 0.05). 3.4 cardiac remodeling index of the remodeling index changes with changes in blood pressure associated T group changes of left ventricular mass (LVM) and diastolic blood pressure (DBP) changes were positively correlated with a correlation coefficient of 0.645 (p lt; 0.01) . 4 simvastatin on cardiac hypertrophy and left ventricular function 4.1 TS myocardial hypertrophy changes in telmisartan-based antihypertensive treatment in plus with simvastatin 1 year, patients of the interventricular septum (IVS ), left ventricular posterior wall thickness (LVPW), left ventricular weight (LVM), left ventricular mass index (LVMI), left ventricular diameter (LVDd) than before decreased (p lt; 0.05), prompted a reversal of left ventricular hypertrophy. 4.2. TS group left ventricular systolic function plus simvastatin years later, the left ventricular ejection fraction EF increased from 57.50 ± 16.41% to 65.43 ± 11.60% in the telmisartan-based antihypertensive treatment ( p lt; 0.01), left ventricular systolic function was significantly improved. The 4.3 TS group changes of left ventricular diastolic function in telmisartan-based antihypertensive therapy plus simvastatin, in patients with left atrial (LA) (p lt; 0.01), E / A reduction The ratio is still a downward trend, but not statistically significant (p gt; 0.05). Septal thickness (IVS) 4.4. TS remodeling indicators of change associated with changes in blood pressure, cardiac remodeling indicators TS group changes with systolic blood pressure (SBP) was positively related to the correlation coefficient is 0.554 (p lt; 0.01). 4.5. Simvastatin on cardiac hypertrophy and left ventricular function (TS group and T-group comparison) treatment group (TS) with the control group (T): use of simvastatin, better able to reduce patients septal thickness (IVS), left ventricular weight (LVM), left ventricular mass index (LVMI) (p lt; 0.05), reversal of cardiac hypertrophy; improve left ventricular ejection fraction (EF) (p lt; 0.01), to improve the Left ventricular systolic function; reversal of left atrial (LA) (p lt; 0.01), but the E / A ratio is still a downward trend in the percentage of the decrease was not statistically significant. Conclusion on the basis of conventional antihypertensive therapy with simvastatin, better able to reduce the patient's systolic blood pressure. 2. Simvastatin reverse left ventricular hypertrophy and improve left ventricular systolic function. 3. Simvastatin may be no reversal of left ventricular diastolic function in hypertensive patients.
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