Are statins effective for simultaneously treating dyslipidemias and hypertension?
3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are unequivocally useful for lowering cholesterol levels in patients with dyslipidemias characterized by elevations in total and/or low-density lipoprotein cholesterol. The beneficial effects of statins to lower serum cholesterol translate into significant reductions in cardiovascular morbidity and mortality. In addition to lowering cholesterol levels, statins have other biological effects relevant to cardiovascular homeostasis including anti-inflammatory actions and downregulation of angiotensin type 1 receptor expression that contribute to improvements in endothelial function and arterial compliance. Since endothelial dysfunction and reduced arterial compliance are important pathophysiological determinants of essential hypertension, these actions of statins raise the possibility that statin therapy may be useful for simultaneously treating dyslipidemias and hypertension. However, it has been unclear whether statins are effective in lowering blood pressure. This controversy stems from a variety of methodological limitations including inadequate sample size, confounding effects of antihypertensive drugs, differences in blood pressure measurement techniques, and differences in patient populations. However, based on published results from both small clinical studies and large randomized clinical trials, statins modestly lower blood pressure in patients with high, but not normal, blood pressure, regardless of cholesterol level.
Vascular Medicine and Atherosclerosis Unit, Division of Cardiology, Gachon University, Gil Medical Center, 1198 Kuwol-dong, Namdong-gu, Incheon 405-760, South Korea. Electronic address: kwangk@gilhospital.com.
Kwang Kon
KK
Koh
Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA.
Michael J
MJ
Quon
Office of Biostatistics Research, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA.
Myron A
MA
Waclawiw
D000818:Animals; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D006973:Hypertension / Q000188:drug therapy*; D015201:Meta-Analysis as Topic; D044140:Receptor, Angiotensin, Type 1 / Q000187:drug effects
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D044140:Receptor, Angiotensin, Type 1