Blood pressure-lowering effect of simvastatin: a placebo-controlled randomized clinical trial with 24-h ambulatory blood pressure monitoring
Blood pressure-lowering effect of simvastatin: a placebo-controlled randomized clinical trial with 24-h ambulatory blood pressure monitoring
复制标题
DOI：
10.1038/jhh.2013.35
复制
发表时间：
2014-01-01
影响因子：
2.7
通讯作者：
Gus, M.
中科院分区：
文献类型：
--
作者：
Correa, V., Jr.;Fuchs, F. D.;Gus, M.
他汀类药物在预防心血管事件中的部分功效可归因于其降血压作用，但主要旨在研究这种作用的临床试验很少。在一项双盲平行安慰剂对照临床试验中，动态血压（ABP）监测，79例高血压患者被随机分配到40 mg辛伐他汀（n = 40）或安慰剂（n = 39），在早晨服用2个月。根据相应的基线BP调整后，ABP变化的组间Δ为2.8 mm Hg（95% CI：0.4-5.1; P = 0.02）24小时舒张压（DBP）为4.2 mm Hg（95% CI：0.1-8.4; P = 0.04）和3.1 mm Hg（95% CI：0.4-5.9; P = 0.02）。对夜间血压没有影响。基线胆固醇水平和治疗效果之间存在相互作用，仅限于胆固醇高于整个样本中位数的患者。办公室血压无显著变化。总之，辛伐他汀降低高血压患者的ABP，特别是在存在较高水平的胆固醇的情况下。这种作用可能有助于他汀类药物在预防心血管疾病方面的有益作用。
Part of the efficacy of statins in the prevention of cardiovascular events can be attributed to their blood pressure-lowering effect, but clinical trials primarily designed to investigate this effect are scarce. In a double-blind parallel placebo-controlled clinical trial with ambulatory blood pressure (ABP) monitoring, 79 hypertensive patients were randomly assigned to 40 mg of simvastatin (n = 40) or placebo (n = 39) taken in the morning for 2 months. Between-group deltas of ABP change, adjusted for the corresponding baseline BP, were 2.8 mm Hg (95% CI: 0.4-5.1; P = 0.02) for 24-h diastolic blood pressure (DBP), 4.2 mm Hg (95% CI: 0.1-8.4; P = 0.04) for daytime systolic BP and 3.1 mm Hg (95% CI: 0.4-5.9; P = 0.02) for daytime DBP. There was no effect on nighttime BP. There was an interaction between baseline cholesterol levels and treatment effect, which was restricted to patients with cholesterol above the median of the whole sample. There was no significant change in office BP. In conclusion, simvastatin lowers ABP in patients with hypertension, particularly in the presence of higher levels of cholesterol. This effect may contribute to the beneficial effects of statins in the prevention of cardiovascular disease.