Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan; Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan.
Mitsukoshi Health and Welfare Foundation, Tokyo, Japan.
J Clin Lipidol. 2017 Jul-Aug;11(4):998-1006. doi: 10.1016/j.jacl.2017.05.015. Epub 2017 Jun 6.
It remains unclear whether treatment of dyslipidemia with 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) reduces the risk of developing hypertension.
In this post-hoc analysis of the Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study, a large-scale primary prevention trial with pravastatin, we examined the preventive effect of pravastatin on the future development of hypertension in patients with hypercholesterolemia.
Of the overall (MEGA) Study population, 3397 nonhypertensive patients at baseline were enrolled in this study. The patients were randomly assigned to either the diet alone group (n = 1722) or the diet plus pravastatin group (n = 1675) and then were followed-up for a median of 36 months to determine new-onset hypertension.
During the follow-up period, 1595 patients developed hypertension (49.1% in the diet alone group and 44.7% in the diet plus pravastatin group). After adjusting for multiple covariates, the diet plus pravastatin group showed a 10% reduction in the risk of developing hypertension (hazard ratio 0.90, 95% confidence interval 0.81-0.998), compared with the diet alone group. Subgroup analyses revealed that the preventive effect of pravastatin on the development of hypertension was pronounced in patients aged ≥60 years, men, those with chronic kidney disease or diabetes mellitus and those without obesity.
Pravastatin reduced the risk of developing hypertension in Japanese patients with hypercholesterolemia. The risk reduction of cardiovascular disease with statins could be partly explained by their preventive effect on the development of hypertension.
目前尚不清楚使用 3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂（他汀类药物）治疗血脂异常是否会降低高血压的发病风险。
在大型原发性预防试验普伐他汀治疗胆固醇升高的原发性预防组（MEGA 研究）的事后分析中，我们检查了普伐他汀对高胆固醇血症患者未来高血压发展的预防作用。
在整个（MEGA）研究人群中，共有 3397 名基线时无高血压的患者纳入本研究。患者被随机分配到单独饮食组（n=1722）或饮食加普伐他汀组（n=1675），然后随访中位数为 36 个月，以确定新发高血压。
在随访期间，有 1595 名患者发生高血压（单独饮食组为 49.1%，饮食加普伐他汀组为 44.7%）。在校正了多个协变量后，饮食加普伐他汀组发生高血压的风险降低了 10%（风险比 0.90，95%置信区间 0.81-0.998），与单独饮食组相比。亚组分析显示，普伐他汀对高血压发展的预防作用在年龄≥60 岁、男性、慢性肾脏病或糖尿病患者以及无肥胖患者中更为显著。
普伐他汀降低了日本高胆固醇血症患者发生高血压的风险。他汀类药物降低心血管疾病风险的部分原因可能是其对高血压发展的预防作用。
