Effects of fluvastatin on insulin resistance and cardiac morphology in hypertensive patients

Among hypertensive patients, cardiovascular disease morbidity is common, even in those who are adequately treated. New pharmacological strategies to mitigate the burden of arterial hypertension are needed. This 12-month, randomized, double-blind placebo-controlled study investigated the effect of statin (fluvastatin) treatment on ambulatory blood pressure (ABP), exercise blood pressure (EBP), myocardial structure, endothelial function and insulin resistance in 50 hypertensive patients. At baseline, the groups were comparable in terms of demographic characteristics, ABP, EBP, endothelial function and homeostasis model assessment of insulin resistance (HOMA-IR). At the end of the study, there was no difference between groups in terms of resting systolic blood pressure. However, maximum systolic EBP was lower in the treatment group than in the placebo group (175 +/- 18 vs 192 +/- 23 mm Hg, P<0.05), as was left ventricular mass index (LVMI; 82 +/- 15 vs 100 +/- 23, P<0.05), and HOMA-IR index was lower after fluvastatin treatment (2.77 +/- 1.46 vs 3.33 +/- 1.73, P<0.05). Changes in lipid profile were not correlated with blood pressure, endothelial function, LVMI or HOMA-IR data. In hypertensive patients, fluvastatin can improve maximum systolic EBP, myocardial remodelling and insulin resistance, independently of lipid profile variations and endothelial function. Journal of Human Hypertension (2011) 25, 492-499; doi: 10.1038/jhh.2010.87; published online 9 September 2010