Pravastatin has an additional depressor effect in patients undergoing long-term treatment with antihypertensive drugs.
BACKGROUND
Statins have been reported to have direct vascular effects independent of cholesterol reduction. To assess the antihypertensive effect of statins, a crossover study was designed to compare the depressor effect of pravastatin and probucol in hypertensive patients undergoing long-term treatment with antihypertensive drugs.


METHODS
The subjects enrolled in this study were 52 hypertensive patients (22 men and 30 women, mean age 62.8 +/- 9.3 years) who were treated with the same antihypertensive drugs for more than 1 year and had serum cholesterol levels of more than 5.69 mmol/L. In 26 subjects, pravastatin at a dose of 10 mg/d was given first for 6 months followed by treatment with probucol at a dose of 500 mg/d, and vice versa in the remaining 26 subjects. Serum lipids, apolipoproteins, glucose, and insulin were measured on the final day of the control period, and pravastatin and probucol treatments. The homeostatic model assessment insulin resistance index (HOMA-IR) was used to assess insulin resistance.


RESULTS
The blood pressure decreased after pravastatin treatment (141.2 +/- 4.7/81.3 +/- 4.9 to 136.5 +/- 5.3/80.6 +/- 5.1 mm Hg, P <.001/.499), but did not decrease after probucol treatment (141.2 +/- 4.7/81.3 +/- 4.9 to 141.4 +/- 4.9/80.8 +/- 4.9 mm Hg, P =.832/.634). Total cholesterol decreased significantly after pravastatin (6.69 +/- 0.69 to 5.23 +/- 0.77 mmol/L, P <.001) and probucol treatment (6.69 +/- 0.69 to 5.53 +/- 0.64 mmol/L, P <.001). The HOMA-IR was decreased by probucol (1.92 +/- 0.78 to 1.57 +/- 0.59, P =.029), whereas pravastatin had no effect on HOMA-IR.


CONCLUSIONS
It can be concluded that the depressor effect of pravastatin may have an additional benefit in the treatment of hypertensive patients with hyperlipidemia without any adverse effect on insulin sensitivity.
Ikeda
Toshio
T
Department of Nephrology, Nippon Telegraph and Telephone Corporation, Kanto Medical Center, Tokyo, Japan. tikeda@tkk.att.ne.jp
Sakurai
Jun
J
Nakayama
Daisuke
D
Takahashi
Yoshihiro
Y
Matsuo
Kiyoko
K
Shibuya
Yuko
Y
Gomi
Tomoko
T
Moriya
Hidekazu
H
Kobayashi
Shuzo
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001055:Apolipoproteins B / Q000187:drug effects; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D008078:Cholesterol, LDL / Q000187:drug effects; D003402:Creatine Kinase / Q000187:drug effects; D018592:Cross-Over Studies; D003971:Diastole / Q000187:drug effects; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000627:therapeutic use*; D013599:Systole / Q000187:drug effects; D013995:Time; D000637:Transaminases / Q000187:drug effects; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D001055:Apolipoproteins B; D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000637:Transaminases; D003402:Creatine Kinase; D017035:Pravastatin