title: Statins, the renin-angiotensin-aldosterone system and hypertension - a tale of another beneficial effect of statins.
abstract: BACKGROUND
  Statins, a class of lipid lowering drugs, decrease mortality associated with cardiovascular events. As hypercholesterolemia is often accompanied by hypertension, a large number of patients receive therapy with statins and antihypertensive drugs which act via the renin-angiotensin-aldosterone system (RAAS). New guidelines published by the American Heart Association and American College of Cardiology on the treatment of dyslipidaemia and the reduction of atherosclerotic cardiovascular risk, which use a risk prediction algorithm based on risk factors such as hypertension but not low-density lipoprotein (LDL) level, may even further increase the number of patients receiving such concomitant therapy.
  
  
  METHODS
  In this paper we review studies on an interaction between statins, the RAAS and antihypertensive drugs acting via the RAAS.
  
  
  RESULTS
  Accumulating evidence suggests that the combination of statins and drugs affecting the RAAS exerts a synergistic effect on the circulatory system. For example, statins may lower arterial blood pressure and augment the effect of antihypertensive drugs acting via the RAAS. Statins may interact with the RAAS in a number of ways i.e. to decrease the expression of receptors for angiotensin II (Ang II), inhibit the Ang II-dependent intracellular signalling, reduce the RAAS-dependent oxidative stress and inflammation as well as inhibit the synthesis of Ang II and aldosterone.
  
  
  CONCLUSIONS
  Although statins given either alone or together with antihypertensive drugs acting via the RAAS may lower arterial blood pressure, further research is needed to evaluate the mechanisms and their therapeutic significance.
authors.affiliation: Department of Experimental and Clinical Physiology, Medical University of Warsaw, Poland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Drapala
authors.affiliation: Department of Experimental and Clinical Physiology, Medical University of Warsaw, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Sikora
authors.affiliation: Department of Experimental and Clinical Physiology, Medical University of Warsaw, Poland mufnal@wum.edu.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Ufnal
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Statins; aldosterone; angiotensin; cardiovascular disease; hypercholesterolaemia; hypertension; renin–angiotensin–aldosterone system