Do statins lower blood pressure as well as cholesterol?

January 01, 0001

Do statins lower blood pressure as well as cholesterol?

A proposed mechanism for the cardiological benefit of statins is that they may also lower blood pressure in addition to lowering cholesterol. These Italian investigators tested this notion through clinic and 24 hour ambulatory blood pressure monitoring in a randomised placebo controlled double blind trial. They enrolled 508 patients with mild hypertension and hyperlipidemia, aged 45-70, in 13 hospitals in Italy. Participants were randomised to antihypertensive treatment (hydrochlorothiazide 25 mg once daily or fosinopril 20 mg once daily) with or without the addition of a statin (pravastatin 40 mg once daily). Blood pressures would measured both in the clinic and with ambulatory blood pressure monitoring throughout the treatment period (average 2.6 year)

The researchers report: "Both the group receiving antihypertensive treatment without pravastatin (n=254) (with little change in total cholesterol) and the group receiving antihypertensive treatment with pravastatin (n=253) (with marked and sustained reduction in total cholesterol and low density lipoprotein cholesterol) had a clear cut sustained reduction in clinic measured systolic and diastolic blood pressure as well as in 24 hour, and day and night, systolic and diastolic blood pressure. Pravastatin performed slightly worse than placebo, and between group differences did not exceed 1.9 mm Hg throughout the treatment period. This was also the case when participants who remained on monotherapy with hydrochlorothiazide or fosinopril throughout the study were considered separately."

The authors concluded: "Administration of a statin in hypertensive patients in whom blood pressure is effectively reduced by concomitant antihypertensive treatment does not have an additional blood pressure lowering effect."

This study finds no evidence supporting the theory that statins also lower blood pressure in addition to lowering cholesterol.

For the full abstract, click here.

BMJ 340: c1197, 25 March 2010
© 2010 Mancia et al.
Statins, antihypertensive treatment, and blood pressure control in clinic and over 24 hours: evidence from PHYLLIS randomised double blind trial. Giuseppe Mancia, Gianfranco Parati, Miriam Revera, et al. Correspondence to G Mancia: [email protected]

Category: K. Circulatory. Keywords: statin, pravastatin, hypertension, blood pressure, PHYLLIS, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 20 April 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.