Influence of atorvastatin on blood pressure control in treated hypertensive, normolipemic patients - An open, pilot study.
OBJECTIVE
The aim of the study was to determine whether a high dose of atorvastatin lowers blood pressure (BP) in normolipemic patients with well controlled primary arterial hypertension and if this effect is associated with alteration of biomarkers of endothelial function and oxidative stress. In this open-label study, normolipemic patients (n=56) were randomized in the proportion of 2:1 to receive atorvastatin 80 mg daily for 3 months (statin-treated, ST n=39), or to previous therapy (statin-free, SF). BP was measured using a 24-h ambulatory BP measurement device. Plasma levels of 6-keto-PGF(1alpha) (prostacyclin metabolite), serum nitric oxide (NO) and levels of autoantibodies immunoglobulin G against oxidatively modified low-density lipoprotein (ox-LDL) were measured.


RESULTS
The mean change in systolic BP and diastolic BP for ST was - 5.7 mmHg (95% CI -4.1 to -7.2 mmHg) and -3.9 mmHg (95% CI -2.7 to -5.0 mmHg), respectively. Hypotensive statin effect was independent of lipid lowering. No change of BP in SF patients was observed. In ST, prostacyclin metabolites and NO concentrations were not significantly increased and autoantibodies against ox-LDL concentrations did not change. In ST, the decrease in BP correlated with increase in NO and decrease in autoantibodies against ox-LDL.


CONCLUSIONS
High-dose atorvastatin resulted in reduction of BP independently of lipid-lowering effect, changes in endothelial function and oxidative stress, but it was related to the increase in NO and decrease in autoantibodies against ox-LDL. However, because of the open design of the study, these results should be carefully debated.
Kuklinska
Agnieszka M
AM
Department of Cardiology, Medical University, Bialystok, Poland. agnieszka.kuklinska@gmail.com
Mroczko
Barbara
B
Musial
Wlodzimierz J
WJ
Sawicki
Robert
R
Kozieradzka
Anna
A
Usowicz-Szarynska
Monika
M
Kaminski
Karol
K
Knapp
Malgorzata
M
Szmitkowski
Maciej
M
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D002784:Cholesterol / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects; D010865:Pilot Projects; D011758:Pyrroles / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
D000959:Antihypertensive Agents; D006538:Heptanoic Acids; D000960:Hypolipidemic Agents; D008077:Lipoproteins, LDL; D011758:Pyrroles; D014280:Triglycerides; D002784:Cholesterol; D000069059:Atorvastatin