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Do Statins Lower Blood Pressure?

Department of Medicine, Mount Sinai School of Medicine, New York, and the James J. Peters VA Medical Center, Bronx, New York

Sanjay Agarwal, MD

Department of Medicine, Mount Sinai School of Medicine, New York, and the James J. Peters VA Medical Center, Bronx, New York

Clive Rosendorff, MD, PhD

Department of Medicine, Mount Sinai School of Medicine, New York, and the James J. Peters VA Medical Center, Bronx, New York, clive.rosendorff{at}med.va.gov

Hypercholesterolemia is present in many patients with hypertension and adds a significant component of cardiovascular risk. The 3-hydroxy-3 methyl-glutarylcoenzyme A reductase inhibitors (statins) lower low-density lipoprotein cholesterol but also inhibit many of the structural and functional components of the arteriosclerotic process. Structural effects include reductions in vascular smooth muscle hypertrophy and proliferation, fibrin deposition, and collagen cross-linking. Among the functional effects are improvements in endothelial function, reduction in inflammatory cytokines and reactive oxygen species, and down-regulation of angiotensin II and endothelin receptors. These would be expected to reduce blood pressure in patients with hypertension; 14 studies have shown statin-induced decrease in blood pressure, but 11 studies showed no effect. Many of the studies had no placebo controls, were of short duration, or had small sample sizes, or combinations of these. Despite predictions made on the basis of the vasoprotective actions of statins, the blood-pressure-lowering effects of statins are at best modest.

Key Words: statins • hypertension • blood pressure

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				B. A. Golomb, J. E. Dimsdale, H. L. White, J. B. Ritchie, and M. H. Criqui Reduction in Blood Pressure With Statins: Results From the UCSD Statin Study, a Randomized Trial Arch Intern Med, April 14, 2008; 168(7): 721 - 727. [Abstract] [Full Text] [PDF]