Golomb Beatrice A, Dimsdale Joel E, White Halbert L, Ritchie Janis B, Criqui Michael H
Department of Medicine, University of California, San Diego,9500 Gilman Dr, No. 0995, La Jolla, CA 92093-0995, USA.
Arch Intern Med. 2008 Apr 14;168(7):721-7. doi: 10.1001/archinte.168.7.721.
Some studies have suggested reductions in blood pressure (BP)with statin treatment, particularly in persons with hypertension. Randomized trial evidence is limited.
We performed a randomized, double-blind, placebo-controlled trial with equal allocation to simvastatin, 20 mg; pravastatin sodium,40 mg; or placebo for 6 months. Nine hundred seventy-three men and women without known cardiovascular disease or diabetes mellitus, with low-density lipoprotein cholesterol screening levels of 115 to 190 mg/dL, had assessment of systolic and diastolic BP (SBP and DBP, respectively). Blood pressure values were compared for placebo vs statins by intention-to-treat (ITT) analysis. Additional analyses were performed that (1) were confined to subjects with neither high baseline BP (SBP>140 mm Hg or DBP>90 mm Hg) nor receiving BP medications, to exclude groups in whom BP medications or medication changes may have influenced results, and (2) separately evaluated simvastatin and pravastatin (vs placebo). The time course of BP changes after statin initiation and the effect of stopping statins on BP were examined.
Statins modestly but significantly reduced BP relative to placebo,by 2.2 mm Hg for SBP (P=.02) and 2.4 mm Hg for DBP (P<.001) in ITT analysis. Blood pressure reductions ranged from 2.4 to 2.8 mm Hg for both SBP and DBP with both simvastatin and pravastatin, in those subjects with full follow-up, and without potential for influence by BP medications (ie, neither receiving nor meriting BP medications).
Reductions in SBP and DBP occurred with hydrophilic and lipophilic statins and extended to normotensive subjects. These modest effects may contribute to the reduced risk of stroke and cardiovascular events reported on statins. Trial Registration clinicaltrials.gov Identifier: NCT00330980.
一些研究表明他汀类药物治疗可降低血压（BP），尤其是高血压患者。随机试验证据有限。
我们进行了一项随机、双盲、安慰剂对照试验，将患者等分为辛伐他汀20毫克组、普伐他汀钠40毫克组或安慰剂组，治疗6个月。973名无已知心血管疾病或糖尿病、低密度脂蛋白胆固醇筛查水平为115至190毫克/分升的男性和女性接受了收缩压和舒张压（分别为SBP和DBP）评估。通过意向性分析（ITT）比较安慰剂组与他汀类药物组的血压值。进行了额外分析，（1）仅限于基线血压不高（SBP>140毫米汞柱或DBP>90毫米汞柱）且未服用降压药物的受试者，以排除降压药物或药物变化可能影响结果的组，（2）分别评估辛伐他汀和普伐他汀（与安慰剂相比）。研究了开始使用他汀类药物后血压变化的时间过程以及停用他汀类药物对血压的影响。
在ITT分析中，与安慰剂相比，他汀类药物适度但显著降低了血压，SBP降低2.2毫米汞柱（P = 0.02），DBP降低2.4毫米汞柱（P<0.001）。在那些接受完整随访且无降压药物影响可能性（即既未服用也无需服用降压药物）的受试者中，辛伐他汀和普伐他汀使SBP和DBP均降低了2.4至2.8毫米汞柱。
亲水性和亲脂性他汀类药物均可降低SBP和DBP，且这种作用扩展至血压正常的受试者。这些适度的作用可能有助于解释他汀类药物降低中风和心血管事件风险的报道。试验注册clinicaltrials.gov标识符：NCT00330980。
