Pravastatin Decreases Blood Pressure in Hypertensive and Hypercholesterolemic Patients Receiving Antihypertensive Treatment

Abstract

any patients with hypertension have concomitant hypercholesterolemia [1][2][3] and it has been reported that reductions in cholesterol levels correlate with lower diastolic blood pressure (DBP). 4 Further, experimental and clinical studies have demonstrated a strong correlation between high plasma cholesterol levels and impaired endothelium-dependent vascular relaxation. [5][6][7] These findings suggest that hypercholesterolemia may contribute to increased vascular reactivity and thereby contribute to systemic hypertension.Several studies have reported that administration of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (ie, statins) can result in reductions in blood pressure (BP) as well as cholesterol. Statins reduced BP and prevented hypertension-induced glomerular injury in Dahl salt-sensitive rats and spontaneously hypertensive rats, [8][9][10][11] and statin treatment alone decreased BP in patients with hypercholesterolemia and untreated hypertension. 12,13 Three studies have reported that concomitant treatment with statins and antihypertensive drugs resulted in better BP control in Western patients with hypertension. [14][15][16] Only 1 study has reported that pravastatin had an additional depressor effect in Japanese patients taking antihypertensive drugs, 17 so the precise BP-lowering effects of statins in Japanese patients remains unclear. Therefore, in the present study designed to assess the different BP-lowering effects of statins and anti-hypertensive drugs, the effect of pravastatin on BP and cholesterol levels was compared between Japanese hypertensive patients who were already receiving antihypertensive treatment and normotensive patients not on antihypertensive treatment. MethodsThe clinical data of 82 patients with hypercholesterolemia (low-density lipoprotein cholesterol (LDL-C) >140 mg/dl) (39 men, 43 women; age range, 40-77 years; mean age, 62±9 years) before and after 3 months of treatment with pravastatin (10 mg/day orally) from January 1990 to December 1995 were retrospectively analyzed. Of these patients 44 had hypertension (HT group) and had been on antihypertensive treatment for at least 1 year; the remaining 38 patients were normotensive (NT group). Patients in the HT group were further subdivided into those with uncontrolled BP (systolic BP (SBP) ≥140 mmHg or DBP ≥90 mmHg) and those with controlled BP (SBP <140 mmHg and SBP <90 mmHg). Patients with diabetes, liver or disease, chronic pancreatitis, cancer, or major cardiovascular complication (myocardial infarction or unstable angina within the past 6 months, or congestive heart failure) were excluded from the study in order to evaluate the direct effect of pravastatin on hypertension with hypercholesterolemia. Those with a diagnosis of secondary hypertension were excluded after standard routine clinical and laboratory examinations. Patients on antihypertensive treatment continued with the same antihypertensive regimen before and after the 3 months of treatment with pravastatin. Background Previous studies have...

Investigation of Blood Lipid Levels and Statin Interventions in Outpatients With Coronary Heart Disease in China The China Cholesterol Education Program (CCEP)

“…Therefore, statins should be prescribed for Chinese CHD patients, besides their benefit of lipid lowering. [26][27][28][29][30] In this study, 82.2% of the participants received statin therapy, which was higher than a result from Japan (36.3%) 31 and from Hong Kong where a report showed that only 37% of participants received lipid-lowering drugs. 32 It is also higher than the results of small trials in China and other reports.…”

Analysis of antihypertensive effects of statins

“…In fact, systolic BP was significantly decreased after pravastatin treatment (from 141.2 ± 4.7 to 136.5 ± 5.3 mm Hg, P < 0.001), whereas no significant changes were noted in diastolic BP levels (from 81.3 ± 4.9 to 80.6 ± 5.1 mm Hg) [36]. It was reported recently that pravastatin exerts an additive "hypotensive" effect in hypercholesterolemic patients receiving antihypertensive therapy [37]. Notably, greater reductions in both systolic and diastolic BP were seen in patients with uncontrolled hypertension.…”

Impact of Statin Therapy on Left Ventricular Function and Carotid Arterial Stiffness in Patients With Hypercholesterolemia

“…[25][26][27] Statins have several pleiotropic effects, including antiinflammatory and immunomodulatory, antithrombotic, and vascular effects, as well as their beneficial lipid-lowering effects. [28][29][30] In the clinical setting, it has been reported that statins improve LV function. Sola et al reported that atorvastatin therapy for 12 months increases LVEF, reduces the LV diameter, and improves several inflammatory markers in patients with nonischemic heart failure.…”