Section of Cardiology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Room 525D, Houston, TX 77030, USA.
Curr Atheroscler Rep. 2010 Sep;12(5):349-54. doi: 10.1007/s11883-010-0086-7.
The effective optimization of the modifiable risk factors for the development of atherosclerosis is the cornerstone preventive cardiology. Risk factor clustering has been demonstrated to occur in a higher prevalence than would be expected by chance alone. The common cardiovascular risk factors frequently share metabolic pathways. Inflammation and oxidative stress are demonstrable in the major cardiovascular risk factors. Hypertension and dyslipidemia frequently co-exist in an individual. The advent of statin therapy has allowed optimization of the lipid profile and achievement of therapeutic goals advocated by the Adult Treatment Panel of the National Cholesterol Education Program. Statin therapy has been demonstrated to exhibit a wide variety of nonlipid or pleiotropic effects. Observational studies have demonstrated that statin therapy may cause a small but statistically significant alteration of blood pressure. Prospective clinical trials have demonstrated that statin therapy reduces this cardiovascular risk in both hypertensive and normotensive individuals. The potential role of statin therapy in blood pressure reduction is compatible with several pleiotropic mechanisms of statin therapy. However, a significant body of data from prospective, well-designed, controlled clinical trials that have analyzed the effect of statin therapy on blood pressure as the primary end point is lacking. This review examines the observational relationship between hypertension and dyslipidemia, the potential mechanisms by which statin therapy may lower blood pressure, and selected clinical trial data.
动脉粥样硬化发生可修正危险因子的有效优化是预防心脏病学的基石。已经证实，危险因子群聚的出现比单独偶然发生的频率更高。常见的心血管危险因子经常共享代谢途径。在主要心血管危险因子中可观察到炎症和氧化应激。高血压和血脂异常经常在个体中共存。他汀类药物治疗的出现使得能够优化血脂谱，并实现国家胆固醇教育计划成人治疗专家组所倡导的治疗目标。他汀类药物治疗已被证实具有广泛的非脂质或多效性作用。观察性研究表明，他汀类药物治疗可能会导致血压的微小但具有统计学意义的变化。前瞻性临床试验表明，他汀类药物治疗可降低高血压和血压正常个体的心血管风险。他汀类药物治疗在降低血压方面的潜在作用与他汀类药物治疗的几种多效性机制兼容。然而，缺乏大量来自前瞻性、精心设计、以他汀类药物治疗对血压的影响作为主要终点的对照临床试验的数据。这篇综述探讨了高血压与血脂异常之间的观察性关系、他汀类药物治疗降低血压的潜在机制以及一些临床试验数据。
