Statin's role on blood pressure levels: Meta‐analysis based on randomized controlled trials

Liu, Hui Ting; Deng, Nian Hua; Wu, Ze Fan; Zhou, Zhan Yang; Zhang, Tian; Liu, Xi Yan; Wang, Yan Xia; Zheng, Hong; Ou, Yang Shao; Jiang, Zhi Sheng

doi:10.1111/jch.14645

Cited by 8 publications

(12 citation statements)

References 76 publications

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“…17,18 statin use, it seems that there was not enough time to confirm the blood pressure-lowering effect of statin. 19 In the present study, not only RSV 20 mg/AML 5 mg but also RSV 10 mg/AML 5 mg achieved more percent reduction of LDL-C and more LDL-C goals than ATV 20 mg/AML 5 mg. This result was similar to the previous comparison of RSV and ATV alone.…”

Section: Discussionsupporting

confidence: 51%

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Randomized, multicenter, parallel, open, phase 4 study to compare the efficacy and safety of rosuvastatin/amlodipine polypill versus atorvastatin/amlodipine polypill in hypertension patient with dyslipidemia

Jung

Kim

Hong

et al. 2023

J of Clinical Hypertension

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The authors performed this study to investigate the efficacy and safety of a rosuvastatin (RSV)/amlodipine (AML) polypill compared with those of atorvastatin (ATV)/AML polypill. We included 259 patients from 21 institutions in Korea. Patients were randomly assigned to 1 of 3 treatment groups: RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, or ATV 20 mg /AML 5 mg. The primary endpoint was the efficacy of the RSV 10.20 mg/AML 5 mg via percentage changes in LDL‐C after 8 weeks of treatment, compared with the ATV 20 mg /AML 5 mg. There was a significant difference in the mean percentage change of LDL‐C at 8 weeks between the RSV 10 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (full analysis set [FAS]: −7.08%, 95% CI: −11.79 to −2.38, p = .0034, per‐protocol analysis set [PPS]: −6.97%, 95% CI: −11.76 to −2.19, p = .0046). Also, there was a significant difference in the mean percentage change of LDL‐C at 8 weeks between the RSV 20 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (FAS: −10.13%, 95% CI: −15.41 to −4.84, p = .0002, PPS: −10.96%, 95% CI: −15.98 to −5.93, p < .0001). There was no significant difference in the adverse events rates between RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, and ATV 20 mg/AML 5 mg. In conclusion, while maintaining safety, RSV 10 mg/AML 5 mg and the RSV 20 mg/AML 5 mg more effectively reduced LDL‐C compared with the ATV 20 mg /AML 5 mg (Clinical trial: NCT03951207).

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Section: Discussionsupporting

confidence: 51%

“…However, they included only prospective randomized, controlled trials that had a minimum follow‐up of at least 2 months. Considering that the blood pressure follow‐up period in our study was 8 weeks after statin use, it seems that there was not enough time to confirm the blood pressure‐lowering effect of statin 19 …”

Section: Discussionmentioning

confidence: 91%

Randomized, multicenter, parallel, open, phase 4 study to compare the efficacy and safety of rosuvastatin/amlodipine polypill versus atorvastatin/amlodipine polypill in hypertension patient with dyslipidemia

Jung

Kim

Hong

et al. 2023

J of Clinical Hypertension

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“…Although statins are unlikely to explain the majority of the 8.3 mmHg lower SBP in statin-treated than statin-eligible untreated adults observed in this report, evidence suggests that statins have a limited effect to lower BP, improve hypertension control, and reduce the likelihood of treatment-resistant hypertension [6][7][8][9][10]14,[29][30][31]. Among statin-eligible adults with treated hypertension, those on statins were more likely to have their hypertension controlled than those not on statins (Table 1).…”

Section: Discussionmentioning

confidence: 72%

“…2). The difference in BP between statin-treated and untreated adults from a representative sample of the US population is greater than reported from randomized controlled trials [10][11][12][13][14]. The mechanism by which statin therapy is associated with lower BP values and higher control rates among adults with hypertension in observational studies is not well defined.…”

Section: Discussionmentioning

confidence: 86%

“…In propensity-score matched adults with hypertension, those on statins had 2–3 mmHg lower SBP on ambulatory monitoring than those not on statins [8]. A recent meta-analysis reported that statins lowered BP 1.42/0.82 mmHg in 45 1734 adults with and without hypertension in 49 randomized controlled trials [14]. On balance, the BP effects of statins appear limited in randomized, controlled trials and unlikely to explain the 1.6–2-fold greater odds ratios for hypertension control in statin-treated than untreated adults in observational studies.…”

Section: Introductionmentioning

confidence: 99%

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Greater use of antihypertensive medications explains lower blood pressures and better control in statin-treated than statin-eligible untreated adults

Egan,

Li,

Sutherland

et al. 2024

Journal of Hypertension

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Objective: Statins appear to have greater antihypertensive effects in observational studies than in randomized controlled trials. This study assessed whether more frequent treatment of hypertension contributed to better blood pressure (BP, mmHg) control in statin-treated than statin-eligible untreated adults in observational studies. Methods: National Health and Nutrition Examination Surveys 2009–2020 data were analyzed for adults 21–75 years (N = 3814) with hypertension (BP ≥140/≥90 or treatment). The 2013 American College of Cardiology/American Heart Association Cholesterol Guideline defined statin eligibility. The main analysis compared BP values and hypertension awareness, treatment, and control in statin-treated and statin-eligible but untreated adults. Multivariable logistic regression was used to assess the association of statin therapy to hypertension control and the contribution of antihypertensive therapy to that relationship. Results: Among adults with hypertension in 2009–2020, 30.3% were not statin-eligible, 36.9% were on statins, and 32.8% were statin-eligible but not on statins. Statin-treated adults were more likely to be aware of (93.4 vs. 80.6%) and treated (91.4 vs. 70.7%) for hypertension than statin-eligible adults not on statins. The statin-treated group had 8.3 mmHg lower SBP (130.3 vs. 138.6), and 22.8% greater control (<140/<90: 69.0 vs. 46.2%; all P values <0.001). The association between statin therapy and hypertension control [odds ratio 1.94 (95% confidence interval 1.53–2.47)] in multivariable logistic regression was not significant after also controlling for antihypertensive therapy [1.29 (0.96–1.73)]. Conclusion: Among adults with hypertension, statin-treated adults have lower BP and better control than statin-eligible untreated adults, which largely reflects differences in antihypertensive therapy.

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Sympathetic modulation as a goal of antihypertensive treatment: from drugs to devices

Grassi

2023

Journal of Hypertension

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The present study aims to examine the effects of nonpharmacological, pharmacological and devices-based treatment on hypertension-related sympathetic overactivity. This will be done by analyzing the results of different published studies, in which sympathetic activity has been assessed via indirect or direct techniques. After examining the rationale for sympathomodulatory interventions in antihypertensive treatment, the study will discuss the methodological intrinsic limitations of the studies aimed at assessing different therapeutic interventions. The core of the study will be then focused on the effects of nonpharmacological (dietary restriction of sodium intake, physical exercise training, weight reduction), pharmacological (monotherapy, combination drug treatment, new drugs such as sodium glucose co-transport protein-2 inhibitors and angiotensin receptor neprilysin inhibitors), as well as devices-based interventions (renal sympathetic nerves ablation and carotid baroreceptor activation therapy) on the hypertension-related sympathetic overdrive. Finally, the areas worthy of future research as well as the debated issues in the field will be highlighted.

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Statin's role on blood pressure levels: Meta‐analysis based on randomized controlled trials

Cited by 8 publications

References 76 publications

Randomized, multicenter, parallel, open, phase 4 study to compare the efficacy and safety of rosuvastatin/amlodipine polypill versus atorvastatin/amlodipine polypill in hypertension patient with dyslipidemia

Randomized, multicenter, parallel, open, phase 4 study to compare the efficacy and safety of rosuvastatin/amlodipine polypill versus atorvastatin/amlodipine polypill in hypertension patient with dyslipidemia

Greater use of antihypertensive medications explains lower blood pressures and better control in statin-treated than statin-eligible untreated adults

Sympathetic modulation as a goal of antihypertensive treatment: from drugs to devices

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