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小剂量阿托伐他汀降低轻中度高血压伴高胆固醇血症患者的动态血压:一项双盲、随机、安慰剂对照研究。

Low-dose atorvastatin reduces ambulatory blood pressure in patients with mild hypertension and hypercholesterolaemia: a double-blind, randomized, placebo-controlled study.

机构信息

Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

J Hum Hypertens. 2012 Oct;26(10):577-84. doi: 10.1038/jhh.2011.80. Epub 2011 Sep 1.

DOI:10.1038/jhh.2011.80
PMID:21881597
Abstract

Among several beneficial cardiovascular actions of statins, experimental studies have suggested that statins may also induce a mild blood pressure (BP) reduction. However, clinical data were controversial and the potential hypotensive statin effect remains uncertain. This study aimed to investigate the effect of atorvastatin on ambulatory BP in patients with mild hypertension and hypercholesterolaemia. A total of 50 patients with mild hypertension and hypercholesterolaemia participated in this double-blind, randomized, placebo-controlled study. Patients were randomized to either 10 mg atorvastatin or placebo for 26 weeks. Background antihypertensive treatment, if any, remained unchanged during follow-up. At baseline and study-end (26 weeks), ambulatory BP monitoring and blood sampling for determination of standard biochemical and safety parameters were performed in all participants. BP loads were defined as the percentage of BP measurements exceeding the hypertension threshold of 140/90 mm Hg for daytime and 125/75 mm Hg nighttime period. Atorvastatin significantly reduced 24-h systolic and diastolic BP (DBP; median (range)) as compared with placebo (-5.0 (-21.0, 4.0) vs +1.0 (-6.0, 7.0) mm Hg, P<0.001 and -3.0 (-16.0, 2.0) vs +0.1 (-7, 4) mm Hg, P<0.01, respectively). Reductions in systolic and DBP loads during follow-up were also evident in the atorvastatin, but not in the placebo group. BP-lowering effects of atorvastatin were consistent in both daytime and nighttime periods. This study shows a mild, but consistent throughout the 24-h period BP-lowering effect of atorvastatin in patients with mild hypertension and hypercholesterolaemia. This beneficial effect of atorvastatin on BP may represent another pathway through which this drug class provides cardiovascular risk reduction.

摘要

在他汀类药物的几种有益心血管作用中,实验研究表明,他汀类药物可能也会引起轻度血压(BP)降低。然而,临床数据存在争议,潜在的降压他汀类药物作用仍不确定。本研究旨在探讨阿托伐他汀对轻度高血压和高胆固醇血症患者的动态血压(BP)的影响。共有 50 名轻度高血压和高胆固醇血症患者参加了这项双盲、随机、安慰剂对照研究。患者被随机分配至 10 mg 阿托伐他汀或安慰剂组,治疗 26 周。随访期间,如果有背景降压治疗,保持不变。所有参与者均在基线和研究结束时(26 周)进行了动态血压监测和血样采集,以测定标准生化和安全性参数。BP 负荷定义为 BP 测量值超过日间 140/90mmHg 和夜间 125/75mmHg 的高血压阈值的百分比。与安慰剂相比,阿托伐他汀显著降低了 24 小时收缩压和舒张压(DBP;中位数(范围))(-5.0(-21.0,4.0)与+1.0(-6.0,7.0)mmHg,P<0.001 和-3.0(-16.0,2.0)与+0.1(-7.0,4.0)mmHg,P<0.01,分别)。阿托伐他汀组的收缩压和 DBP 负荷在随访期间也有下降,但安慰剂组没有。阿托伐他汀组在白天和夜间均表现出降压作用。本研究显示,阿托伐他汀在轻度高血压和高胆固醇血症患者中具有轻度但持续的 24 小时降压作用。阿托伐他汀对 BP 的有益作用可能代表了这种药物类别提供心血管风险降低的另一种途径。

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