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他汀类药物对血压水平的作用:基于随机对照试验的荟萃分析。

Statin's role on blood pressure levels: Meta-analysis based on randomized controlled trials.

机构信息

Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerosis of Hunan Province, Hengyang Medical College, University of South China, Hengyang, Hunan, PR China.

Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, PR China.

出版信息

J Clin Hypertens (Greenwich). 2023 Mar;25(3):238-250. doi: 10.1111/jch.14645. Epub 2023 Feb 17.

Abstract

Statins have been proven to be effective in minimizing the risk of cardiovascular adverse events, however, their effect on BP variability is debatable with respect to their significance and their use as a potential anti-hypertensive. Using a meta-analysis approach, the aim of this study was to explore whether certain statins have the potential to lower blood pressure (BP). For the period 2002-2022, Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched for the studies that examined the effect of statins on blood pressure in normotensive or hypertensive individuals. Randomized controlled clinical trials that investigated this effect were included based on our inclusion criteria. Our primary outcomes were changes in systolic and diastolic blood pressure (DBP). The final analysis of the study included 49 RCTs involving 45 173 participants randomized to receive either statins or placebo. Among the two groups, the total weighted mean difference (WMD) for systolic blood pressure (ΔSBP) was -1.42 (95% CI: -2.38, -0.46; p = .004) and diastolic blood pressure (ΔDBP) was 0.82 (95% CI: -1.28, -0.36; p = .0005). Despite various studies suggesting the efficacy of statins in blood pressure lowering to be significant and non-significant both, we observed a decrease in SBP and DBP both, although the change was not as large and could be considered significant. A large multicenter, multi-ethnic, large sample pool size, and a long period follow-up study is still required to assert these claims.

摘要

他汀类药物已被证明可有效降低心血管不良事件的风险,但关于其对血压变异性的影响及其作为潜在抗高血压药物的意义仍存在争议。本研究采用荟萃分析方法,旨在探讨某些他汀类药物是否具有降低血压的潜力。在 2002 年至 2022 年期间,我们检索了 Scopus、PubMed、Web of Science 和 Cochrane 对照试验中心注册数据库,以寻找研究他汀类药物对正常血压或高血压个体血压影响的研究。根据纳入标准,纳入了研究这种影响的随机对照临床试验。我们的主要结局是收缩压和舒张压的变化。本研究的最终分析纳入了 49 项 RCT,涉及 45173 名随机接受他汀类药物或安慰剂治疗的参与者。在两组中,收缩压的总加权均数差值(WMD)为-1.42(95%CI:-2.38,-0.46;p=0.004),舒张压的 WMD 为 0.82(95%CI:-1.28,-0.36;p=0.0005)。尽管有许多研究表明他汀类药物在降低血压方面具有显著和不显著的疗效,但我们观察到收缩压和舒张压都有所下降,尽管变化不大,但可以认为是显著的。仍需要进行一项大型多中心、多民族、大样本量和长期随访研究来证实这些结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb4/9994171/8a853569d178/JCH-25-238-g006.jpg

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