Novel concepts of statin therapy for cardiovascular risk reduction in hypertension.
Hypertension is associated with an increase in cardiovascular events. Pathophysiological mechanisms of this include endothelial damage/dysfunction, inflammatory activation, insulin resistance, platelet activation and alterations in the coagulation cascade leading to a prothrombotic state. Dyslipidaemia acts synergistically with hypertension in increasing cardiovascular risk. HMG CoA reductase inhibitors (statins) are lipid-lowering drugs and more recently have been shown to have a significant pleiotropic effect on endothelial function, inflammation, platelet activation and coagulation. Statins affect the whole pathophysiology of atherogenesis from deposition to plaque rupture and thrombogenesis because of its pleiotropic effects. Therefore it is intuitive that statins may be of benefit in hypertensive patients with conventionally normal lipid levels by preventing the pathological effects of hypertension. There is an increasing clinical evidence base for statins use in patients with hypertension. In this article, the novel pleiotropic and conventional mechanisms of statins, and clinical data of statin therapy in patients with hypertension are reviewed.
Varughese
George I
GI
Department of Cardiology and Vascular Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B18 7QH, England.
Patel
Jeetesh V
JV
Lip
Gregory Y H
GY
Varma
Chetan
C
D001777:Blood Coagulation / Q000187:drug effects; D001792:Blood Platelets / Q000187:drug effects / Q000502:physiology; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D050171:Dyslipidemias / Q000188:drug therapy; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D005342:Fibrinolysis / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007249:Inflammation / Q000517:prevention & control; D050356:Lipid Metabolism / Q000187:drug effects; D012307:Risk Factors; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors