Use of statins and blood pressure.
BACKGROUND
Markers of inflammation such as high-sensitivity C-reactive protein (CRP) were shown to be elevated in patients with hypertension. Small trials using statin therapy showed blood-pressure (BP) reductions, but it is unknown whether this association extends to larger populations. The objective of this study was to determine whether statin use was associated with better blood-pressure control in adults with hypertension and whether inflammation levels mediated this relationship.


METHODS
This was a cross-sectional study of 2584 hypertensive adults aged >or=40 years with no known cardiovascular disease from the National Health and Nutrition Examination Survey 1999-2002. Logistic regression models were calculated to determine whether there was an association between statin use and blood-pressure control. C-reactive protein was added to the full model to determine its impact on the association.


RESULTS
Compared with people not using statin medication, significantly more statin users had their blood pressure under control (52.2% v 38.0%). After adjustment for demographic factors, statin users were two times (95% confidence interval [CI], 1.46 to 2.72) more likely to have their blood pressure under control (<140/90 mm Hg) than nonusers. After further adjustment for body mass index, diabetes, smoking, exercise, low-salt diet, and antihypertensive medications, the likelihood of having blood pressure under control remained more likely among statin users (odds ratio, 1.46; 95% CI, 1.05 to 2.05). The association between statin use and lower BP was most evident among participants who used antihypertensive medication as well as statins and was unchanged with the addition of CRP to the model.


CONCLUSIONS
Statin use was associated with a BP level <140/90 mm Hg in a representative sample of US adults with hypertension. Levels of CRP did not attenuate the association. Further studies are needed to explore the effects of statin use on blood pressure and to determine how best to apply this knowledge in clinical care.
King
Dana E
DE
Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. kingde@musc.edu
Mainous
Arch G
AG
Egan
Brent M
BM
Player
Marty
M
Geesey
Mark E
ME
D001794:Blood Pressure / Q000187:drug effects*; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein