title: Simvastatin improves the attenuated heart rate recovery of type 2 diabetics.
abstract: Heart rate recovery at 1min (HRR1) is a strong predictor of all-cause mortality. The effects of statins on the autonomic nervous system may account for their beneficial effects in survival. Our aim was to determine if statin therapy improves heart rate recovery in hypercholesterolemic patients with type 2 diabetes mellitus. Thirty type 2 diabetic patients without known coronary artery disease and low density lipoprotein cholesterol>100mg/dl and 30 age and sex matched non-diabetic controls were included in a prospective study. Patients with diabetes were treated with simvastatin 40mg/day for 1 year. No lipid-lowering therapy was administered to the control group. Exercise testing with 2min cool-down period was performed at baseline, 6, 12 weeks and at 1 year. The diabetics had significantly lower HRR1 compared with non-diabetics at baseline (19.2+/-5.4bpm versus 24.2+/-4bpm, p<0.0001). Simvastatin therapy significantly improved HRR1 after 12 weeks compared to baseline (19.2+/-5.4bpm versus 24+/-5bpm, p<0.0001) and this improvement remained significant at 1 year (26+/-4.4bpm, p<0.0001 compared to baseline). HRR1 did not change in the control group (p=0.39 by ANOVA). This study demonstrates that treatment with simvastatin might improve the attenuated heart rate recovery of diabetic subjects. In patients with diabetes, the mortality benefit provided by statins might involve their effects on the autonomic nervous system.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Başkent University, Adana, Turkey. goknurtek@yahoo.com
authors.forename: Göknur
authors.initials: G
authors.lastname: Tekin
authors.forename: Abdullah
authors.initials: A
authors.lastname: Tekin
authors.forename: Taner
authors.initials: T
authors.lastname: Canatar
authors.forename: Ilke
authors.initials: I
authors.lastname: Sipahi
authors.forename: Aydan
authors.initials: A
authors.lastname: Unsal
authors.forename: Tuna
authors.initials: T
authors.lastname: Katircibaşi
authors.forename: Tolga
authors.initials: T
authors.lastname: Koçum
authors.forename: Tansel
authors.initials: T
authors.lastname: Erol
authors.forename: Fatma
authors.initials: F
authors.lastname: Yiğit
authors.forename: Senol
authors.initials: S
authors.lastname: Demircan
authors.forename: Necip
authors.initials: N
authors.lastname: Ermiş
authors.forename: Alpay Turan
authors.initials: AT
authors.lastname: Sezgin
authors.forename: Haldun
authors.initials: H
authors.lastname: Müderrisoğlu
mesh_terms: D001341:Autonomic Nervous System / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D019821:Simvastatin / Q000627:therapeutic use*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D008055:Lipids; D019821:Simvastatin