NEW ORLEANS — Treatment with either simvastatin or pravastatin led to significant reductions of both systolic and diastolic blood pressure that averaged about 2.5 mm Hg in a controlled study with 1,016 patients, Beatrice A. Golomb, M.D., reported at the annual scientific sessions of the American Heart Association.
“Some patients who are on the cusp of having hypertension and are not on antihypertensive therapy may benefit from the statin effect,” which may help them continue to avoid needing a blood pressure-lowering drug, said Dr. Golomb, a cardiologist at the University of California, San Diego. This modest degree of blood pressure reduction may explain the ability of statin therapy to cut the risk of stroke, a finding that has been hard to attribute to lipid-lowering effects.
The study enrolled men and postmenopausal women who did not have heart disease, diabetes, or hypertension, and whose LDL-cholesterol level was 115–190 mg/dL. These people were randomized to treatment with 20 mg/day simvastatin, 40 mg/day pravastatin, or placebo, and treatment continued for 6 months.
After 6 months of treatment, systolic BP had fallen by an average of 2.8 mm Hg in the simvastatin group and by 2.5 mm Hg in the pravastatin group, compared with baseline. Diastolic pressures had dropped by an average of 2.7 mm Hg and 2.5 mm Hg, compared with baseline in the simvastatin and pravastatin groups, respectively. Once patients were off statin treatment for 2 months, these BP reductions largely disappeared.
The results of a second study presented at the meeting suggested that the blood pressure-lowering effect of a statin is independent of the drug's lipid-lowering effect. This analysis used data collected from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT).
One part of the study randomized a 10,305-patient subgroup to treatment with either 10 mg of atorvastatin daily or placebo. BPs recorded in this subset were evaluated in a post hoc analysis to explore whether atorvastatin had any effect.
Although all patients in the study were on combined regimens of antihypertensive drugs, those who also received atorvastatin had small but consistently lower systolic and diastolic BPs than the patients who did not receive statin therapy, reported Bjorn Dahlof, M.D., professor of medicine at the University of Goteborg (Sweden).
The 5,168 patients treated with atorvastatin had an average systolic pressure that was about 1 mm Hg lower than that among 5,137 patients treated with placebo at several times during 3 years of follow-up. Diastolic BP averaged about 0.6 mm Hg lower in the atorvastatin group, compared with those on placebo.