Sirenko Yuriy, Radchenko Ganna
National Scientific Center, Strazhesko Institute of Cardiology, 5, Narodnogo Opolcheniya Street, Kiev, 03680, Ukraine.
High Blood Press Cardiovasc Prev. 2017 Mar;24(1):85-93. doi: 10.1007/s40292-017-0184-5. Epub 2017 Feb 2.
Several lines of research indicate that statins can lower blood pressure (BP) independently of their lipid-lowering effects when used as monotherapy and in combination with antihypertensive agents.
This short-term, open-label study examined whether statin therapy had a synergistic effect on the BP-lowering efficacy of perindopril/amlodipine in a subgroup of patients in the PERSPECTIVA study with concomitant hypertension and hypercholesterolemia, with or without statin at baseline.
The PERSPECTIVA study recruited 732 adults with untreated or uncontrolled hypertension. This subgroup analysis of PERSPECTIVA included 587 patients with concomitant hypertension and hypercholesterolemia (mean age 56.7 years) of whom 226 were receiving a statin at baseline (statin [+] group) and 361 were not (statin [-] group). All patients received treatment with single-pill combination perindopril/amlodipine at a dose of 5/5, 10/5 or 10/10 mg/day. The study duration was 60 days with follow-up visits for BP monitoring at 7, 15, 30 and 60 days.
At day 60, BP control (<140/90 mmHg) was significantly greater in the statin [+] vs statin [-] group: 73 vs 64% respectively (+14%, P < 0.05). In the statin [+] group, the single-pill perindopril/amlodipine combination significantly reduced BP in patients previously untreated (n = 18), or treated with monotherapy (n = 97), dual therapy (n = 93), or triple therapy (n = 18): -38.8/-20.0, -39.1/-20.1, -38.0/-19.4, -39.9/-18.3 mmHg respectively (P < 0.001 vs baseline BP). The greatest BP reductions were observed in the first 7 days. Treatment was well tolerated with a similar rate of adverse events in the statin [+] group (0.9%) vs the statin [-] group (2.5%).
BP control rates in patients with uncontrolled hypertension and concomitant hypercholesterolemia are significantly improved with a treatment regimen that combines perindopril/amlodipine with statin therapy, regardless of previous antihypertensive therapy. This subanalysis of the PERSPECTIVA study supports the synergistic BP-lowering effect of statins and perindopril/amlodipine.
多项研究表明，他汀类药物在作为单一疗法使用以及与抗高血压药物联合使用时，可独立于其降脂作用降低血压（BP）。
这项短期、开放标签研究探讨了在PERSPECTIVA研究中伴有高血压和高胆固醇血症的亚组患者中，无论基线时是否使用他汀类药物，他汀类药物治疗对培哚普利/氨氯地平的降压疗效是否具有协同作用。
PERSPECTIVA研究招募了732名未经治疗或血压控制不佳的成年人。该PERSPECTIVA研究的亚组分析纳入了587例伴有高血压和高胆固醇血症的患者（平均年龄56.7岁），其中226例在基线时接受他汀类药物治疗（他汀类药物[+]组），361例未接受（他汀类药物[-]组）。所有患者均接受培哚普利/氨氯地平单片复方制剂治疗，剂量为5/5、10/5或10/10mg/天。研究持续时间为60天，在第7、15、30和60天进行随访以监测血压。
在第60天时，他汀类药物[+]组的血压控制（<140/90mmHg）显著高于他汀类药物[-]组：分别为73%和64%（提高14%，P<0.05）。在他汀类药物[+]组中，培哚普利/氨氯地平单片复方制剂使既往未治疗（n=18）、接受单一疗法（n=97）、联合疗法（n=93）或三联疗法（n=18）的患者血压显著降低：分别降低-38.8/-20.0、-39.1/-20.1、-38.0/-19.4、-39.9/-18.3mmHg（与基线血压相比，P<0.001）。在最初7天观察到最大的血压降幅。治疗耐受性良好，他汀类药物[+]组（0.9%）与他汀类药物[-]组（2.5%）的不良事件发生率相似。
无论既往抗高血压治疗情况如何，培哚普利/氨氯地平与他汀类药物联合治疗方案可显著提高未控制高血压和伴有高胆固醇血症患者的血压控制率。PERSPECTIVA研究的这项亚组分析支持他汀类药物与培哚普利/氨氯地平的协同降压作用。
