Saturday, March 24, 2007
statins en bloeddruk
Statins lower blood pressure
19 March 2007
Statins produce small but clinically meaningful reductions in blood pressure (BP), meta-analysis results indicate.
The statin-induced BP changes are unrelated to effects on cholesterol, report Pasquale Strazzullo (Federico II University of Naples Medical School, Italy) and co-authors in the journal Hypertension.
The researchers conducted a meta-analysis of 20 randomized, controlled trials and found a small but significant reduction in systolic (S)BP and a trend towards a reduction in diastolic (D)BP with statin therapy.
Several studies have already documented the antihypertensive effects of statins, Strazzullo and colleagues explain, but these have been inconclusive owing to limitations such as small sample size, short treatment periods, and changes to concomitant antihypertensive therapy.
The team therefore conducted a systematic review of existing trials of statin therapy, including studies in which concomitant antihypertensive therapy was used only if this was not altered during follow-up.
The 20 trials included a total of 828 patients, 291 of whom were allocated to statin treatment groups and 272 to control groups, while 265 participated in crossover trials. The control groups received placebo in 18 trials, the lipid-lowering drug probucol in one, and fluvastatin plus orlistat (an inhibitor of intestinal lipid digestion) in another.
Overall, SBP was significantly lower in statin-treatment groups than in placebo or control hypolipidemic drug groups, by 1.9 mmHg. Statin therapy also lowered DBP, but to a lesser extent, with a mean overall reduction of 0.9 mmHg.
The effect of statin therapy on BP was greater in studies that included patients with higher baseline BP levels. For example, when the researchers restricted their analysis to studies including patients with baseline SBP >130 mmHg, statin therapy reduced SBP by an average of 4 mmHg.
Meanwhile, in studies including patients with average baseline DBP >80 mmHg, statin therapy reduced DBP by 1.2 mmHg.
In contrast, in studies where SBP was <130 mmHg, and/or DBP <80 mmHg, the average net effect of statins on either SBP or DBP was negligible.
Meta-regression analysis showed no evidence of any relationship between the response to statin therapy and age, length of the trial, baseline serum cholesterol, change in serum total cholesterol or low-density lipoprotein cholesterol, presence of diabetes, or use of antihypertensive drugs by at least some patients.
“Whatever the mechanism(s), our meta-analysis provided evidence of a favorable effect of statins on BP, particularly SBP, and indicated that the effect was larger in individuals with elevated BP,” the authors conclude.
Hypertension 2007; Advance online publication
© Copyright Current Medicine Group Ltd, 2006
19 March 2007
Statins produce small but clinically meaningful reductions in blood pressure (BP), meta-analysis results indicate.
The statin-induced BP changes are unrelated to effects on cholesterol, report Pasquale Strazzullo (Federico II University of Naples Medical School, Italy) and co-authors in the journal Hypertension.
The researchers conducted a meta-analysis of 20 randomized, controlled trials and found a small but significant reduction in systolic (S)BP and a trend towards a reduction in diastolic (D)BP with statin therapy.
Several studies have already documented the antihypertensive effects of statins, Strazzullo and colleagues explain, but these have been inconclusive owing to limitations such as small sample size, short treatment periods, and changes to concomitant antihypertensive therapy.
The team therefore conducted a systematic review of existing trials of statin therapy, including studies in which concomitant antihypertensive therapy was used only if this was not altered during follow-up.
The 20 trials included a total of 828 patients, 291 of whom were allocated to statin treatment groups and 272 to control groups, while 265 participated in crossover trials. The control groups received placebo in 18 trials, the lipid-lowering drug probucol in one, and fluvastatin plus orlistat (an inhibitor of intestinal lipid digestion) in another.
Overall, SBP was significantly lower in statin-treatment groups than in placebo or control hypolipidemic drug groups, by 1.9 mmHg. Statin therapy also lowered DBP, but to a lesser extent, with a mean overall reduction of 0.9 mmHg.
The effect of statin therapy on BP was greater in studies that included patients with higher baseline BP levels. For example, when the researchers restricted their analysis to studies including patients with baseline SBP >130 mmHg, statin therapy reduced SBP by an average of 4 mmHg.
Meanwhile, in studies including patients with average baseline DBP >80 mmHg, statin therapy reduced DBP by 1.2 mmHg.
In contrast, in studies where SBP was <130 mmHg, and/or DBP <80 mmHg, the average net effect of statins on either SBP or DBP was negligible.
Meta-regression analysis showed no evidence of any relationship between the response to statin therapy and age, length of the trial, baseline serum cholesterol, change in serum total cholesterol or low-density lipoprotein cholesterol, presence of diabetes, or use of antihypertensive drugs by at least some patients.
“Whatever the mechanism(s), our meta-analysis provided evidence of a favorable effect of statins on BP, particularly SBP, and indicated that the effect was larger in individuals with elevated BP,” the authors conclude.
Hypertension 2007; Advance online publication
© Copyright Current Medicine Group Ltd, 2006
# posted by roodbont @ 8:08 AM 
