Do statins lower blood pressure?
Hypercholesterolemia is present in many patients with hypertension and adds a significant component of cardiovascular risk. The 3-hydroxy-3 methyl-glutarylcoenzyme A reductase inhibitors (statins) lower low-density lipoprotein cholesterol but also inhibit many of the structural and functional components of the arteriosclerotic process. Structural effects include reductions in vascular smooth muscle hypertrophy and proliferation, fibrin deposition, and collagen cross-linking. Among the functional effects are improvements in endothelial function, reduction in inflammatory cytokines and reactive oxygen species, and down-regulation of angiotensin II and endothelin receptors. These would be expected to reduce blood pressure in patients with hypertension; 14 studies have shown statin-induced decrease in blood pressure, but 11 studies showed no effect. Many of the studies had no placebo controls, were of short duration, or had small sample sizes, or combinations of these. Despite predictions made on the basis of the vasoprotective actions of statins, the blood-pressure-lowering effects of statins are at best modest.
Mangat
Simardeep
S
Department of Medicine, Mount Sinai School of Medicine, New York, and the James J. Peters VA Medical Center, Bronx, New York 10468, USA.
Agarwal
Sanjay
S
Rosendorff
Clive
C
D000818:Animals; D001161:Arteriosclerosis / Q000188:drug therapy / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects*; D008078:Cholesterol, LDL / Q000187:drug effects / Q000378:metabolism*; D002986:Clinical Trials as Topic; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D006937:Hypercholesterolemia / Q000188:drug therapy / Q000503:physiopathology; D006973:Hypertension / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000494:pharmacology*
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents