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他汀类药物的降压作用:一项安慰剂随机对照试验的系统文献回顾和荟萃分析。

Blood pressure-lowering activity of statins: a systematic literature review and meta-analysis of placebo-randomized controlled trials.

机构信息

Saudi Biobank, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs (MNG-HA), P.O. Box 3660, 11481 Mail Code, Riyadh, 1515, Saudi Arabia.

Pharmacy Services Department, Security Forces Hospital Program, Riyadh, Saudi Arabia.

出版信息

Eur J Clin Pharmacol. 2020 Dec;76(12):1745-1754. doi: 10.1007/s00228-020-02965-2. Epub 2020 Jul 21.

Abstract

PURPOSE

To investigate the blood pressure (BP)-lowering effects of statins by conducting a systematic review and meta-analysis of placebo-randomized controlled trials (RCTs).

METHOD

We conducted a meta-analysis of placebo RCTs reporting antihypertensive effects of statins therapy. We only included RCTs that did not allow for concomitant antihypertensive therapy, or clearly stated that antihypertensive therapy was fixed throughout the study period.

RESULTS

Our meta-analysis included 46 placebo RCTs, including 53 group comparisons and a total of 49,087 participants (24,589 participants in the statin groups and 24,498 participants in the placebo group). Subgroup analysis, based on use of concomitant antihypertensive, was performed. The meta-analysis showed that statin reduced systolic BP by - 1.6 mmHg (95% CI: - 2.50 to - 0.60), and diastolic BP by - 0.96 mmHg (95% CI: - 1.36 to - 0.56). Although the presence of concomitant antihypertensive therapy diluted the BP lowering effect of statins, it remained statistically significant and independent of the lipid-lowering activity. Furthermore, the BP -lowering effect of the statins was independent of the dose or type of statin (p > 0.05).

CONCLUSION

Our results strengthen the evidence for pleiotropic effects of statins on BP that are independent of their lipid-lowering activity, supporting their beneficial role in hypertensive patients with dyslipidemia.

摘要

目的

通过系统评价和荟萃分析安慰剂对照随机对照试验(RCT)来研究他汀类药物的降压作用。

方法

我们对报告他汀类药物治疗降压作用的安慰剂对照 RCT 进行了荟萃分析。我们仅纳入不允许同时进行降压治疗的 RCT,或明确说明在整个研究期间固定使用降压治疗的 RCT。

结果

我们的荟萃分析纳入了 46 项安慰剂对照 RCT,包括 53 组比较,共有 49087 名参与者(他汀组 24589 名,安慰剂组 24498 名)。我们进行了基于是否同时使用降压药物的亚组分析。荟萃分析显示,他汀类药物可降低收缩压 -1.6mmHg(95%CI:-2.50 至 -0.60),舒张压 -0.96mmHg(95%CI:-1.36 至 -0.56)。虽然同时使用降压药物会削弱他汀类药物的降压效果,但这种效果仍然具有统计学意义且独立于降脂活性。此外,他汀类药物的降压效果与剂量或类型无关(p>0.05)。

结论

我们的结果加强了他汀类药物对血压的多效作用的证据,这些作用独立于其降脂活性,支持他汀类药物在伴有血脂异常的高血压患者中的有益作用。

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