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Pravastatin Can Significantly Decrease Systolic Blood Pressure in Moderately Hypertensive Patients With Hyperlipidaemia
A DGReview of :"Pravastatin has an additional depressor effect in patients undergoing long-term treatment with antihypertensive drugs"
American Journal of Hypertension
06/17/2004
By Shane Alexander
The depressor effect of pravastatin may be an additional benefit when treating moderately hypertensive patients with hyperlipidaemia, according to a team of Japanese researchers.
The investigators, led by Toshio Ikeda, MD, Department of Nephrology, Nippon Telegraph and Telephone Corporation, enrolled 52 Japanese subjects (22 men; mean age 62.8 years) with moderate, established, primary hypertension who had been treated with the same antihypertensive drugs for more than 1 year. All patients had a serum cholesterol level in excess of 220 mg/dL.
The randomised, open, controlled, 2 X 2 cross-over trial, consisted of a 6-month run-in period with antihypertensive drugs, a 6-month active treatment with pravastatin or probucol (period 1), a 1-month washout period, and a 6-month treatment period with the alternative treatment (period 2).
Pravastatin 10 mg/day and probucol 500 mg/day were used during each treatment period. Blood samples were collected at baseline and after each treatment period and relevant parameters were evaluated. Blood pressure and pulse rate were measured every 4 weeks.
Systolic blood pressure (BP) decreased significantly by 4.7 mm Hg after pravastatin treatment but remained unchanged after probucol treatment. Pravastatin caused a decrease in pulse measure of 4.0 mm Hg.
Both pravastatin and probucol decreased serum total cholesterol, LDL cholesterol and apolipoprotein B. Serum insulin levels were decreased by 17.3% with probucol, bur were not changed by pravastatin.
"Because the 2 drugs did not affect plasma levels of glucose, homeostatic model assessment insulin resistance (HOMA-IR) index was decreased by 18.2% with probucol indicating that probucol induced improvement of insulin resistance," the authors report.
The incidence of increase in transaminases was higher with pravastatin treatment than with probucol treatment (P = .039).
"The patients in this study had BP moderately controlled with various antihypertensive drugs at an average 141 mm Hg," write the authors. "We observed significant reduction of systolic BP by 4.7 mm Hg using a strictly controlled crossover protocol and obtained clinical evidence of the add-on antihypertensive effect of pravastatin in moderately controlled hypertensive patients."
Am J Hypertens 2004 Jun;17:6:502-6
"Pravastatin has an additional depressor effect in patients undergoing long-term treatment with antihypertensive drugs"
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