Controversial results were reported as to a possible blood pressure-lowering
effect of statins. This may relate to methodological limitations (blood
pressure measuring techniques) or to putative different effects of statins
in different biologic conditions (cholesterol or blood pressure levels, age,
etc). Patients with cholesterol>200 mg/dL and no previous statin treatment
underwent 24-hour ambulatory blood pressure (ABP) monitoring and were
classified as normotensives or hypertensives according to their ABP. They
were randomized to statin (n=51, simvastatin or pravastatin, 10-20 mg/d;
atorvastatin, 5-10 mg/d) or control treatment (n=23, soy lecithin, 20 g/d)
for 2 months, after which ABP assessment was repeated. No consistent
treatment-related reduction in ABP was observed in lecithin-treated patients
(either hypertensives or normotensives) or in statin-treated normotensive
patients (-0.7+/-5.1/-1.0+/-4.6 mm Hg, both P=ns). In contrast, statin-treated
hypertensive patients showed lower systolic and diastolic blood pressure
(-5.7+/-5.8/-3.5+/-3.9 mm Hg, both P<0.001), the effect was entirely
accounted for by reduced daytime values with no change in nighttime values,
and it was unrelated to the concomitant statin-induced cholesterol
reduction. Statins moderately but significantly lower blood pressure in
patients with high (but not with normal) ABP; the effect is confined to the
daytime period and is unrelated to the extent of the cholesterol lowering.
Reference:
J Cardiovasc Pharmacol. 2005 Sep;46(3):310-5. |