Department of Cardiology, Medical University, M. Skłodowskiej-Curie 24A, PL15-276 Białystok, Poland.
Pharmacol Rep. 2010 Sep-Oct;62(5):883-90. doi: 10.1016/s1734-1140(10)70348-0.
We sought to determine if atorvastatin lowers blood pressure in patients with previously diagnosed and well-controlled essential arterial hypertension and if this effect could be related to anti-inflammatory and anti-oxidative effects. Among 92 patients with essential arterial hypertension, we studied 56 non-smoking and normolipemic: 39 were randomized to receive 80 mg atorvastatin daily for 3 months (statin-treated patients, ST), and the rest continued a previous hypotensive therapy (statin-free patients, SF). Blood pressure was measured using a 24-h ambulatory blood pressure measurement device. Serum levels of high-sensitivity C-reactive protein (hs-CRP), total antioxidant status (TAS) and plasma peroxides (assessed by Oxystat) were measured in both groups. The mean change in systolic BP (SBP) for atorvastatin was -5.7 mmHg (95% confidence interval CI, -4.1 to -7.2 mmHg), and the mean change in diastolic BP (DBP) was -3.9 mmHg (95% CI, -2.7 to -5.0 mmHg). No change in BP in SF patients was observed. In the ST group, hs-CRP and peroxides did not significantly decrease. In the SF group, concentrations of hs-CRP proceeded to decrease while peroxides increased. In the ST group, changes in hs-CRP correlated with changes in total cholesterol and low-density lipoprotein cholesterol (r = 0.41, p = 0.013 and r = 0.35, p = 0.04, respectively) but did not correlate with changes in BP. The hypotensive statin effect was independent of the hypolipemic effect. During three months of observation, TAS concentrations in both groups remained stable. In this randomized study, additionally administered atorvastatin to non-smoking and normolipemic patients with well-controlled essential arterial hypertension resulted in reduction of BP. This effect was not followed by significant changes in hs-CRP, TAS or Oxystat concentrations. The hypotensive effect of atorvastatin did not depend on anti-inflammatory, anti-oxidative or hypolipemic actions.
我们试图确定阿托伐他汀是否会降低已确诊且控制良好的原发性动脉高血压患者的血压,以及这种效果是否与抗炎和抗氧化作用有关。在 92 名原发性动脉高血压患者中,我们研究了 56 名非吸烟和正常血脂的患者:39 名随机接受每日 80 毫克阿托伐他汀治疗 3 个月(他汀治疗患者,ST),其余患者继续接受先前的降压治疗(无他汀治疗患者,SF)。使用 24 小时动态血压测量设备测量血压。在两组中均测量了高敏 C 反应蛋白(hs-CRP)、总抗氧化状态(TAS)和血浆过氧化物(通过 Oxystat 评估)的血清水平。阿托伐他汀的收缩压(SBP)平均变化为-5.7mmHg(95%置信区间 CI,-4.1 至-7.2mmHg),舒张压(DBP)平均变化为-3.9mmHg(95%CI,-2.7 至-5.0mmHg)。SF 组患者的血压无变化。在 ST 组中,hs-CRP 和过氧化物没有明显减少。在 SF 组中,hs-CRP 浓度继续下降,而过氧化物浓度增加。在 ST 组中,hs-CRP 的变化与总胆固醇和低密度脂蛋白胆固醇的变化相关(r=0.41,p=0.013 和 r=0.35,p=0.04),但与血压变化无关。降压他汀类药物的作用独立于降脂作用。在三个月的观察期间,两组的 TAS 浓度保持稳定。在这项随机研究中,在控制良好的原发性动脉高血压的非吸烟和正常血脂患者中额外给予阿托伐他汀可降低血压。这一效果并没有导致 hs-CRP、TAS 或 Oxystat 浓度的显著变化。阿托伐他汀的降压作用不依赖于抗炎、抗氧化或降脂作用。