Role and significance of statins in the treatment of hypertensive patients

Stępień, Mariusz; Banach, Maciej; Mikhailidis, Dimitri P.; Gluba, Anna; Kjeldsen, Sverre E.; Rysz, Jacek

doi:10.1185/03007990903098081

Cited by 33 publications

(24 citation statements)

References 49 publications

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“…In addition, decrease of BP with statin therapy was most often significant among patients with hypertension. [3,9,11] On the other hand, studies reporting that statins do not have a BP lowering effect are also found. Banach et al carried out a meta analysis of published literature studies to evaluate the antihypersntive effect of statins in normotensive subjects.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] From the literature, statins have been shown to promote the actions that may contribute to vasodilation such as increase in endothelial production of nitric oxide (NO) and inhibition of reactive oxygen species (ROS) production. [7,8] However there is still a controversy whether statin use leads to any significant blood pressure lowering properties, [8][9][10][11] possible due to heterogeneity of study groups including different level of dyslipidemia types, different types of antihypertensive drugs and different patient population. So far, only one study has been carried out to examine the BP lowering efficacy of rosuvastatin in combination with valsartan in Korean population [1] but no other studies have been carried out to examine the efficacy of rosuvastatin monotherapy in Korean population.…”

Section: Introductionmentioning

confidence: 99%

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Blood pressure lowering effect of statin drugs with an application to rosuvastatin

Heo

Son

Park

2016

Transl Clin Pharmacol

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Hyperlipidemia and hypertension are among the major risk factors for cardiovascular disease (CVD) and they often co-exist within a single patient. Recently, many studies published results regarding the potential role of statins in decreasing blood pressure (BP) however there is still a controversy over the efficacy of statin therapy on BP. This study aimed to investigate the potential role of rosuvastatin in BP lowering properties in Korean population. Data were taken from three randomized, multiple-dose cross over studies for rosuvastatin, angiotensin II receptor blocker (ARB) and metformin monotherapies and the combined therapy of rosuvastatin and ARB, in total of 91 healthy male normotensive subjects. Measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP) at the baseline before treatment begins and for 24 hours after the last dose were used in the analysis. The analysis variables used were (i) the mean change in steady-state BP from the baseline, symbolized as ΔBP, and (ii) the difference in ΔBP between the ARB monotherapy and the combined therapy, symbolized as ΔBP,d. The △BP and ΔBP,d for SBP from each study varied in -0.1 ~ -1.3 mmHg and 1.2 ~ 1.6 mmHg, respectively, and were not significantly different from zero. The △BP and ΔBP,d for DBP from each study varied in -2.8 ~ -1.4 mmHg and -2.9 ~ -1.8, respectively, which were statistically significant for △BP (p < 0.05) but was not for ΔBP,d (p > 0.05). These results indicated that the rosuvastatin monotherapy may produce small blood pressure lowing effect in DBP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Blood pressure lowering effect of statin drugs with an application to rosuvastatin

Heo

Son

Park

2016

Transl Clin Pharmacol

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“…However, apart from their lipid-lowering effects, statins may also exert additional pleiotropic effects such as: the reduction of oxidative stress, thrombogenesis, fibrosis and inflammation due to the decrease in IL-6, MCP-1, TGF-β and intracellular adhesion molecule-1 (ICAM) as well as the improvement of endothelial dysfunction [110,162]. It has also been demonstrated that statins exert significant BP-lowering effects, particularly on systolic BP [161,[163][164][165]. Furthermore, animal models revealed that statins decrease the severity of lipid-induced glomerular damage and thus preserve renal function [110,[166][167][168].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Metabolic syndrome and renal disease

Gluba

Mikhailidis

Lip

et al. 2013

International Journal of Cardiology

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“…6,7 These potential BP-lowering properties are further supported by background data, which have uncovered a number of statin actions that could contribute to BP amelioration. 5,8,9 Despite the rather solid mechanistic background, the findings of human studies evaluating the statin effects on BP seem rather conflicting. Early clinical studies in this field suffered from important methodological limitations (uncontrolled and non-randomized designs, small sample sizes, and short duration of follow-up).…”

Section: Introductionmentioning

confidence: 97%

Low-dose atorvastatin reduces ambulatory blood pressure in patients with mild hypertension and hypercholesterolaemia: a double-blind, randomized, placebo-controlled study

et al. 2011

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Among several beneficial cardiovascular actions of statins, experimental studies have suggested that statins may also induce a mild blood pressure (BP) reduction. However, clinical data were controversial and the potential hypotensive statin effect remains uncertain. This study aimed to investigate the effect of atorvastatin on ambulatory BP in patients with mild hypertension and hypercholesterolaemia. A total of 50 patients with mild hypertension and hypercholesterolaemia participated in this double-blind, randomized, placebo-controlled study. Patients were randomized to either 10 mg atorvastatin or placebo for 26 weeks. Background antihypertensive treatment, if any, remained unchanged during follow-up. At baseline and study-end (26 weeks), ambulatory BP monitoring and blood sampling for determination of standard biochemical and safety parameters were performed in all participants. BP loads were defined as the percentage of BP measurements exceeding the hypertension threshold of 140/90 mm Hg for daytime and 125/75 mm Hg nighttime period. Atorvastatin significantly reduced 24-h systolic and diastolic BP (DBP; median (range)) as compared with placebo (-5.0 (-21.0, 4.0) vs +1.0 (-6.0, 7.0) mm Hg, P<0.001 and -3.0 (-16.0, 2.0) vs +0.1 (-7, 4) mm Hg, P<0.01, respectively). Reductions in systolic and DBP loads during follow-up were also evident in the atorvastatin, but not in the placebo group. BP-lowering effects of atorvastatin were consistent in both daytime and nighttime periods. This study shows a mild, but consistent throughout the 24-h period BP-lowering effect of atorvastatin in patients with mild hypertension and hypercholesterolaemia. This beneficial effect of atorvastatin on BP may represent another pathway through which this drug class provides cardiovascular risk reduction.

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Role and significance of statins in the treatment of hypertensive patients

Abstract: At present, it is difficult to unequivocally assess the impact of statins on blood pressure. However, according to most authors, the impact of statins on the decrease in BP is slight, but significant, especially among patients with hypertension.

Cited by 33 publications

References 49 publications

Blood pressure lowering effect of statin drugs with an application to rosuvastatin

Blood pressure lowering effect of statin drugs with an application to rosuvastatin

Metabolic syndrome and renal disease

Low-dose atorvastatin reduces ambulatory blood pressure in patients with mild hypertension and hypercholesterolaemia: a double-blind, randomized, placebo-controlled study

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