Pulmonary Hypertension Clinical Trial
Official title:
Simvastatin as a Treatment for Pulmonary Hypertension
The purpose of the study is to investigate the safety and efficacy of adding simvastatin to the current conventional treatment regimen for the management of pulmonary hypertension.
Pulmonary arterial hypertension (PAH) is a disease that is characterised by progressive
narrowing of the blood vessels of the lungs. This results in a pressure load on the heart and
heart failure.
The narrowing is in part due to constriction but mostly due to structural changes in affected
vessels. The structural changes affect all cell components of the vessel wall (the
endothelial lining, the muscle layer and fibrous tissue) and can lead to local clot
formation. In addition there is evidence of inflammation of the vessels and what is known as
oxidative stress. The disease may occur with no obvious cause, when it is known as
idiopathic, but it can also be associated with a variety of other diseases, including
congenital heart disease, collagen vascular disease and HIV infection.
Current approaches to the treatment of pulmonary hypertension are unsatisfactory as they do
not prevent disease progression and do not directly or adequately address many of the
processes detailed above. Alternative or additional treatments are therefore required and an
attrative approach is to use a statin (a 3-hydroxy-3-methylglutaryl-coenzymeA, or HMG-CoA,
reductase inhibitor). Statins are widely used for their ability to lower blood cholesterol
but increasing evidence indicates that these drugs also have direct effects on cell
components of the vessel wall - including inhibiting inflammation, clot formation and
oxidative stress - that might be beneficial in pulmonary hypertension.
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