Milionis Haralampos J, Liberopoulos Evagelos N, Elisaf Moses S, Mikhailidis Dimitri P
Department of Clinical Biochemistry, Vascular Disease Prevention Clinics, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
Curr Hypertens Rep. 2007 Jun;9(3):175-83. doi: 10.1007/s11906-007-0032-4.
Hypertension and hyperlipidemia, two powerful risk factors of cardiovascular disease (CVD), often coexist. Therefore, treatment should consider the beneficial properties of drugs used to treat either condition. Statins, the mainstay of lipid-lowering therapy, result in a significant clinical benefit both in primary and secondary CVD prevention. In addition to their hypolipidemic capacity, other properties may contribute to statin-induced benefits. Clinical and experimental evidence indicates that statins may modulate blood pressure (BP). The mechanisms by which statins reduce BP seem to be largely independent of their lipid effects. Although small, reductions in BP are possibly clinically relevant. Large landmark studies confirm that statins can reduce CVD risk in hypertensive patients. These findings suggest that statins could be prescribed as an adjunct in treating hypertension with dyslipidemia or even in patients with "normal" cholesterol levels. Whether the effect of statins on BP is accompanied by an additional decrease in clinical outcomes needs to be investigated in long-term, large-scale trials.
高血压和高脂血症是心血管疾病(CVD)的两大重要危险因素,常并存。因此,治疗应考虑用于治疗任一病症的药物的有益特性。他汀类药物是降脂治疗的主要药物,在原发性和继发性CVD预防中均产生显著的临床益处。除了其降血脂能力外,其他特性可能也有助于他汀类药物带来益处。临床和实验证据表明,他汀类药物可能会调节血压(BP)。他汀类药物降低血压的机制似乎在很大程度上独立于其脂质效应。虽然血压降低幅度较小,但可能具有临床相关性。大型标志性研究证实,他汀类药物可降低高血压患者的CVD风险。这些发现表明,他汀类药物可作为治疗伴有血脂异常的高血压患者甚至胆固醇水平“正常”患者的辅助药物。他汀类药物对血压的影响是否会伴随临床结局的进一步改善,需要在长期、大规模试验中进行研究。