Diastolic dysfunction (DD) is an increasingly frequent condition in hypertensive individuals whose treatment remains unclear. Its presence is related to higher morbidity and mortality independent of blood pressure levels. The aim of this study is to investigate the additive effect of simvastatin on enalapril on DD in hypertensive patients with average cholesterol levels. For this aim, hypertensive patients with DD and LDL-cholesterol \<160 mg/dL will undergo a run-in phase to achieve a systolic blood pressure (SBP) \<135 mmHg and diastolic blood pressure (DBP) \<85 mmHg with enalapril. Hydrochlorothiazide could be added when need to achieve SBP or DBP control. Four weeks after reaching the optimum anti-hypertensive regimen patients will be randomized to receive 80 mg simvastatin or placebo for a period of 20 weeks. Echocardiograms will be performed before and after treatment with measurement of left atrial volume, conventional and tissue Doppler velocities in early diastole and late diastole. The evaluation of these will allow to identify changes of DD severity after treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
55
80 mg once a day
1 pill once a day
Instituto de Cardiologia do Distrito Federal
Brasília, Federal District, Brazil
Changes in E/A ratio and e' wave velocity
Time frame: 20 weeks
Changes in left atrium volume.
Time frame: 20 weeks
Changes in left ventricular mass.
Time frame: 20 weeks
Changes in e´/a´ waves ratio.
Time frame: 20 weeks
Changes in mitral deceleration time.
Time frame: 20 weeks
Changes in the ratio of mitral inflow velocity to annular relaxation velocity.
Time frame: 20 weeks
Changes in mitral annulus systolic velocity
Time frame: 20 weeks
Diastolic function reserve index measured at peak stress with dobutamine
Time frame: 20 weeks
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