Effects of Statins on Arterial Blood Pressure: a Blinded Clinical Randomized Trial

Document Type : Research Paper

Authors

1 Assistant Professor of Cardiology, Yasooj University of medical Sciences, Yasooj, Iran

2 Professor of Cardiology, Emam sajjad Hospital

3 Associated Professor of Statistics, Yasooj University of medical Sciences, Yasooj, Iran

Abstract

Introduction
Now attention focuses on additional actions of statins which are independent from 3 hydroxy3 methylglutarylcoenzyme a reductase inhibition of them. The aim of this study was antihypertensive effect of statins.
Materials and Methods
We performed a randomized, -blinded, placebo-controlled trial with equal allocation to simvastatin, 20 mg; or placebo for 6 months from December 2008 till June 2009. one hundred patients without known cardiovascular disease or diabetesmellitus, with low-density lipoprotein cholesterol screening levels of 130 to 190 mg/dL & BP <140/90 mm Hg ,had assessment of BP at rest in supine position(SBP and DBP, respectively)in monthly manner for two months. Bloodpressure values for placebo vs statins were compared.
Results
The average of blood pressure in the statin group was124.8/81.12 and in the placebo was 123.75/87.125. Statins modestly but significantly reduced BP relative to placebo, 115.5/71.9(p= 0.02)) in one month after treatment. In placebo group BP reached to 124.25/84.25. However in the second month systolic blood pressure decreased but the diastolic blood pressure increased by one MM/HG (p= 0.5). In Theplacebo group blood pressure increased to 128.32/89.6.
Conclusion
Reductions in SBPandDBP occurred withstatinsin normotensive and prehypertensive subjects. These modest effects may contribute to the reduced risk of strokeandcardiovascular events and the mortality reported onstatins.

Keywords


1- Liszka HA, Sally M. Kerry, Prehypertension and cardiovascular morbidity. Ann Fam Med 2005; 3:294-299.
2- MICHAEL S. Antonio Barbato, RECEPTOR-MEDIATED PATHWAYCHOLESTEROL HOMEOSTASIS, Nobel
lecture, 9 December, 1985.
3- Leu HB, Versiero M. Fluvastatin reduces oxidative stress, decreases serum monocyte chemotactic protein-1 level and
improves endothelial function in patients with hypercholesterolemia. J Formos Med Assoc 2004; 103:914-920.
4- Hognestad A, Lanfranco D’Elia. Effects of conventional and aggressive statin treatment on markers of endothelial
function and inflammation. Clin Cardiol 2004; 27:199-203.
5-Yildirir A, Francesco P. Cappuccio non-lipid effects of statins: emerging new indications. Curr Vasc Pharmacol.
2004; 2:309-318.
6- Landmesser U Kultursay H, Kayikcioglu M. Simvastatin versus ezetimibe: pleiotropic and lipid-lowering effects on
endothelial function in humans. Circulation. 2005; 111:2356-2363.
7- Karatzis E Jorge PA, Almeida EA. Rapid effect of pravastatin on endothelial function and lipid peroxidation in
unstable angina. Int J Cardiol 2005; 101:65-70.
8- Jorge PA, Krum H, Conway EL Jorge M, Carneiro A. Effects of atorvastatin, fluvastatin, pravastatin, and simvastatin
on endothelial function, lipid peroxidation, and aortic atherosclerosis in hypercholesterolemic rabbits [in Portuguese].
Arq Bras Cardiol 2005; 84:314.
9- Beishuizen ED, Troffa C. The effect of statin therapy on endothelial function in type 2 diabetes without manifest
cardiovascular disease. Diabetes Care 2005; 28:1668-1674.
10- Tantikosoom W, Leibovitz E, Hazanov N, Zimlichman R, Shargorodsky M, Gavish D. Randomized trial of
atorvastatin in improving endothelial function in diabetics without prior coronary disease and having average
cholesterol level. J Med Assoc Thai 2005; 88:399-406.
11- Avest E, Derosa G, Mugellini A, Ciccarelli L. Effects of rosuvastatin on endothelial function in patients with
familial combined hyperlipidaemia (FCH). Curr Med Res Opin 2005; 21:1469-1462. - Beatrice A, Reduction in Blood
Pressure With Statins, JAMA, 2008; 168: 7.
12- Golomb BA, Kayikcioglu M. The UCSD Statin Study: a randomized controlled trial assessing the impact of statins
on selected noncardiac outcomes. Control Clin Trials 2004; 25:178-202.
13- Leu HB, Kanbay M, Yildirir A, Bozbas H, Chen JW.l. Fluvastatin reduces oxidative stress, decreases serum
monocyte chemotactic protein-1 level and improves endothelial function in patients with hypercholesterolemia. J
Formos Med Assoc 2004; 103:914-920.
14- Golomb BA. Conceptual foundations of the UCSD Statin Study: a randomized controlled trial assessing the impact
of statins on cognition, behavior,and biochemistry. Arch Intern Med 2004; 164:153-162.
15 Strazzullo P. Do statins reduce blood pressure? a meta - -analysis of randomized,controlled trials. Hypertension.
2007; 49:792-798.
16- Sarafidis PA, Ciccarelli L, Fogari R. Statins and blood pressure: is there an effect or not? J Clin Hypertens
(Greenwich). 2007; 9:460-467.
17- Mangat S, Agarwal S, Rosendorff C. Do statins lower blood pressure? J Cardiovasc Pharmacol Ther 2007; 12:112-123 .
18- Tonelli M, Ferrier KE, Muhlmann MH, Baguet JP, Lopez-Jimenez F, Jhangri GS, et al. Effect of pravastatin on
blood pressure in people with cardiovascular disease. J Hum Hypertens 2006; 20:560-565.
19- Kanbay M, Golomb BA, Criqui MH, White H, Dimsdale JE. Statin therapy helps to control blood pressure levels
in hypertensive dyslipidemic patients. Ren Fail 2005; 27:297-303 .
20 - Kshirsagar AV. Blood pressure usually considered normal is associated with an elevated risk of cardiovascular
disease. Am J Med 2006; 119:133-141.