Banach Maciej, Nikfar Shekoufeh, Rahimi Roja, Bielecka-Dabrowa Agata, Pencina Michael J, Mikhailidis Dimitri P, Narkiewicz Krzysztof, Rysz Jacek, Ray Kausik K, Abdollahi Mohammad
Department of Hypertension, Medical University of Lodz, Poland.
Int J Cardiol. 2013 Oct 3;168(3):2816-24. doi: 10.1016/j.ijcard.2013.03.068. Epub 2013 Apr 18.
The aim of this meta-analysis was to investigate whether statin therapy is associated with blood pressure (BP)-lowering in patients with or without hypertension.
The beneficial effects of statins on the cardiovascular system may in part be related to effects beyond lipid-lowering. It has been suggested that statins may reduce BP; however the available data are still ambiguous and often conflicting.
Data from Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials for the years 1966-January 2012 were searched for studies that investigated the effect of statins on BP in normotensive or in hypertensive subjects. We included all randomized controlled clinical trials that investigated this effect. Changes in systolic and diastolic BP were the key outcomes of interest.
The final analysis included 18 trials and 5628 subjects (4692 normotensive and 936 hypertensive patients) randomized to receive either statins or placebo. The weighted mean difference of systolic (∆SBP) and diastolic blood pressure (∆DBP) in normotensive patients for the 11 statin trials included were 0.03 (95% CI: -0.95-1.02; p = 0.95) and -0.28 (95% CI: -0.80-0.24; p = 0.29), respectively. For hypertensive patients treated with statins (8 trials) the weighted mean difference of ∆SBP and ∆DBP were 1.45 (95% CI: -0.49-3.39; p = 0.14) and -1.32 (95% CI: -3.93-1.28; p = 0.32) respectively.
Despite previous suggestions statin therapy in normotensive or hypertensive patients does not lead to significant reductions in systolic or diastolic BP.
本荟萃分析旨在研究他汀类药物治疗是否与有或无高血压患者的血压降低相关。
他汀类药物对心血管系统的有益作用可能部分与降脂以外的作用有关。有人提出他汀类药物可能降低血压；然而，现有数据仍不明确且常常相互矛盾。
检索了Scopus、PubMed、科学网以及1966年至2012年1月的Cochrane对照试验中央注册库中的数据，以查找研究他汀类药物对正常血压或高血压受试者血压影响的研究。我们纳入了所有研究此效应的随机对照临床试验。收缩压和舒张压的变化是主要关注的结局。
最终分析纳入了18项试验和5628名受试者（4692名正常血压患者和936名高血压患者），这些受试者被随机分配接受他汀类药物或安慰剂。纳入的11项他汀类药物试验中，正常血压患者收缩压（∆SBP）和舒张压（∆DBP）的加权平均差分别为0.03（95%CI：-0.95-1.02；p = 0.95）和-0.28（95%CI：-0.80-0.24；p = 0.29）。对于接受他汀类药物治疗的高血压患者（8项试验），∆SBP和∆DBP的加权平均差分别为1.45（95%CI：-0.49-3.39；p = 0.14）和-1.32（95%CI：-3.93-1.28；p = 0.32）。
尽管之前有相关提示，但他汀类药物治疗在正常血压或高血压患者中并不会导致收缩压或舒张压显著降低。
