Statins reduced systolic and diastolic blood pressure, even in normotensive subjects and those with “prehypertension,” in a secondary analysis of data collected in the University of California, San Diego, Statin Study.
Both simvastatin, the most lipophilic statin, and pravastatin, the most hydrophilic statin, were found to decrease blood pressure “substantially, although the mean absolute magnitude of the change was modest in this largely nonhypertensive sample receiving relatively low statin dosages,” Dr. Beatrice A. Golomb and her associates at the university reported based on their analysis.
The investigators used data from the large 6-month UCSD Statin Study to assess the impact of the anticholesterol drugs on blood pressure because data from many small studies have suggested that statins improve hypertension.
However, these studies “have been correlational, uncontrolled, tested against other active drugs with uncertain impact on BP, unblinded, nonrandomized, or without assessment of statistical significance,” they noted.
In contrast, the UCSD Statin Study randomly assigned 973 participants (about 68% men) to 20 mg/day simvastatin, 40 mg/day pravastatin, or placebo in a double-blind fashion and assessed several factors, including blood pressure, at 1 month and 6 months, as well as at 2 months after the study was completed.
Blood pressure level was not a primary end point of the initial analysis.
The mean age of the placebo patients was nearly 58 years; the treated patient mean was nearly 57 years. More than 80% of the patients were white.
In the secondary analysis by Dr. Golomb and her associates, all of the participants, regardless of their blood pressure status at baseline, showed reductions in systolic and diastolic pressure after 1 month of statin treatment, though the difference between active therapy and placebo was nonsignificant at that point.
By 6 months, the participants in both of the statin groups showed significant reductions in blood pressure, compared with participants in the placebo group.
For both drugs, the reductions in blood pressure ranged from 2.4 to 2.8 mm Hg for both systolic and diastolic blood pressure.
However, these differences had dissipated at follow-up assessment 2 months after the treatment was discontinued, reported Dr. Golomb and her associates (Arch. Intern. Med. 2008;168:721-7).
Statin-induced decreases in blood pressure, although they might be “modest,” may well “contribute to reductions in transient ischemic attacks and stroke” that have been reported with statin therapy, they added.
Participants who had normal blood pressure, as well as those with “prehypertension,” showed declines in blood pressure similar to those seen with hypertension, according to the findings of the analysis.
This refutes the findings of a previous study in which researchers suggested that statins decrease only high blood pressure, the investigators noted.
The current study excluded participants who had diabetes, known cardiovascular disease, and very high or very low LDL cholesterol levels, so the findings might not extend to those groups, the researchers added.