Study of the effect of statins on inflammatory markers in salt-sensitive and salt-resistant hypertensive patients

Background and purpose: Increased salt intake is thought to be associated withhypertension development, while it contributes to the increased cardiovascular risk thataccompanies salt sensitivity. Arterial hypertension is characterized by endothelialdysfunction, which plays a pivotal role in the pathogenesis of atherosclerosis. Statin usehas contributed significantly to the reduction of the morbidity and mortality ofcardiovascular disease, through both their lipid lowering and pleiotropic actions. The aimof the present study was to investigate whether the administration of simvastatin for 4weeks has any favorable effects in levels of diverse markers of inflammatory activation insalt-sensitive and salt-resistant essential hypertensive patients.Methods: The entire population consisted of 40 consecutive newly-diagnosed untreatedpatients with essential hypertension stage I-II (25 men, mean age=50 years, office bloodpressure=150/96 mmHg). Based on the protocol for assessment of salt sensitivity and thechange in 24h mean arterial pressure (ǻMAP) between the high-sodium and the lowsodiumperiods, patients were divided into two groups: those with salt sensitivity (ǻMAP ≥Ν8mmHg, n=16) and those with salt resistance (ǻMAP 0.14), indicated alarge effect size for both groups, being greater for the salt-sensitivity group. Within theentire population as well as the two studied subgroups, the treatment-related reductions inlevels of inflammatory markers were not significantly correlated to the concomitant statininducedreduction in total serum cholesterol or LDL cholesterol (p=NS).Conclusions: In newly-diagnosed untreated patients with essential hypertension,administration of simvastatin for 4 weeks led to statistically significant reduction in levelsof hs-CRP, MCP-1 and sVCAM-1 in both subgroups of salt-resistant and salt-sensitivesubjects, being greater in the latter. The findings of our study contribute to the furtherunderstanding of the pleiotropic mechanisms of statins and the importance of saltsensitivity in the setting of hypertension