Abstract 3948: Simvastatin Improves the Attenuated Heart Rate Recovery of Type 2 Diabetics
Introduction: Attenuated heart rate recovery (HRR) after exercise, a marker of reduced parasympathetic activity is a powerful predictor of mortality. It has been also demonstrated that diabetes mellitus is associated with attenuated HRR. Although the prognostic significance of HRR is well known, less is known about its modification. Statins may evoke salutary neural effects. Some data suggests that the effects of statins on the autonomic nervous system are part of their pleiotropic efficacy.
Hypothesis: We assessed the hypothesis that statin therapy might improve the attenuated HRR in diabetic patients.
Methods: 30 type 2 diabetic patients without known coronary artery diseaseand LDL cholesterol > 100 mg/dl and 30 age and sex matched nondiabetic 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 2 minute cool-down period was performed at baseline, 6, 12 weeks and at 1 year.
Results: At baseline diabetics had a significiantly lower HRR at 1 minute (HRR1) compared with nondiabetics (19.2 ± 5.4 vs. 24.2 ± 4 bpm, p < 0.0001). After 12 weeks, simvastatin therapy significantly improved HRR1 as compared to baseline (24 ± 5 vs. 19.2 ± 5.4 bpm, p < 0.0001) (Figure⇓). This improvement in HRR1 remained significant after 1 year of treatment with simvastatin (26 ± 4.4 bpm, p < 0.0001 compared to baseline).
Conclusion: These findings for the first time demonstrate that statins can improve the attenuated HRR in diabetic subjects. Autonomic effects may be one of the mechanisms of the improved survival associated with the use of statins.