Simvastatin and Diastolic Dysfunction
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Purpose
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.
| Condition | Intervention | Phase |
|---|---|---|
|
Diastolic Dysfunction Hypertension |
Drug: Simvastatin Drug: Placebo |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Effect of the Addition of Simvastatin to Enalapril in Hypertensive Individuals With Average Cholesterol Levels and Diastolic Dysfunction |
- Changes in E/A ratio and e' wave velocity [ Time Frame: 20 weeks ] [ Designated as safety issue: No ]
- Changes in left atrium volume. [ Time Frame: 20 weeks ] [ Designated as safety issue: No ]
- Changes in left ventricular mass. [ Time Frame: 20 weeks ] [ Designated as safety issue: No ]
- Changes in e´/a´ waves ratio. [ Time Frame: 20 weeks ] [ Designated as safety issue: No ]
- Changes in mitral deceleration time. [ Time Frame: 20 weeks ] [ Designated as safety issue: No ]
- Changes in the ratio of mitral inflow velocity to annular relaxation velocity. [ Time Frame: 20 weeks ] [ Designated as safety issue: No ]
- Changes in mitral annulus systolic velocity [ Time Frame: 20 weeks ] [ Designated as safety issue: No ]
- Diastolic function reserve index measured at peak stress with dobutamine [ Time Frame: 20 weeks ] [ Designated as safety issue: No ]
| Enrollment: | 55 |
| Study Start Date: | November 2006 |
| Study Completion Date: | August 2009 |
| Primary Completion Date: | July 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: Placebo
Placebo
|
Drug: Placebo
1 pill once a day
Other Name: Placebo
|
|
Experimental: Simvastatin
Simvastatin 80 mg/day
|
Drug: Simvastatin
80 mg once a day
Other Name: Zocor
|
Eligibility| Ages Eligible for Study: | 40 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- men or postmenopausal women aged between 40 and 65 years old
- normal fasting blood glucose (<100 mg/dL) and glucose tolerance test (<140 mg/dL)
- waist circumference < 102 cm (men) or < 88cm (women)
- triglycerides <150 mg/dL, LDL cholesterol ≤ 160 mg/dl
- creatinine <1.2 mg/dL, sinus rhythm
- the presence of grade 1 or 2 of DD with an ejection fraction of left ventricle > 55%
- absence of myocardial ischemia during dobutamine stress echocardiography
Exclusion Criteria:
- thyroid dysfunction
- acute or chronic liver disease
- regular use of 3 or more antihypertensive drugs
- secondary hypertension
- symptoms or history of atherosclerotic disease
- valvular dysfunction
- LVH 14 and use of statins in the last 6 months
Contacts and Locations| Brazil | |
| Instituto de Cardiologia do Distrito Federal | |
| Brasilia, DF, Brazil, 70000.000 | |
| Principal Investigator: | Adenalva LS Beck, MD | Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil |
| Study Chair: | Andrei C Sposito, MD, PhD | University of Brasilia Medical School, Brasilia, Brazil |
| Principal Investigator: | Maria E Otto, MD, PhD | Instituto de Cardiologia do Distrito Federal, Brasilia, Brazil |
More Information
No publications provided by Brasilia Heart Study Group
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Andrei C Sposito, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil |
| ClinicalTrials.gov Identifier: | NCT01061450 History of Changes |
| Other Study ID Numbers: | Statin_DD |
| Study First Received: | February 2, 2010 |
| Last Updated: | February 2, 2010 |
| Health Authority: | Brazil: National Committee of Ethics in Research |
Keywords provided by Brasilia Heart Study Group:
|
Diastolic dysfunction hypertension Statins ACE inhibitor Echocardiography |
Additional relevant MeSH terms:
|
Hypertension Vascular Diseases Cardiovascular Diseases Simvastatin Hypolipidemic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action |
Pharmacologic Actions Lipid Regulating Agents Therapeutic Uses Hydroxymethylglutaryl-CoA Reductase Inhibitors Anticholesteremic Agents Enzyme Inhibitors |
ClinicalTrials.gov processed this record on May 16, 2013