Long-term effects of statins on arterial pressure and stiffness of hypertensives
Long-term effects of statins on arterial pressure and stiffness of hypertensives
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DOI：
10.1038/sj.jhh.1001786
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发表时间：
2005-02-01
影响因子：
2.7
通讯作者：
Saruta, T
中科院分区：
文献类型：
--
作者：
Ichihara, A;Hayashi, M;Saruta, T
尽管降低血压 (BP) 可以减少主动脉僵硬度，但实现建议的血压目标可能很困难。最近的研究表明，短期使用他汀类药物可以显着降低血压。为了确定他汀类药物对血压和主动脉僵硬度的长期影响，对 85 名降压治疗未能充分控制血压的高脂血症高血压患者进行了一项单盲随机前瞻性研究。每 3 个月，通过测量脉搏波速度 (PWV) 来评估主动脉僵硬度。患者被随机分配到接受普伐他汀、辛伐他汀、氟伐他汀或非他汀类降脂药治疗的组。研究开始时，四组患者特征、降压药物种类、血压、踝臂指数、PWV、血脂、肌酐或C反应蛋白水平没有显着差异。在12个月的治疗期间，普伐他汀组或非他汀组的PWV没有变化，但辛伐他汀组的PWV短暂降低，氟伐他汀组显着降低，尽管本研究中使用的他汀类药物剂量低于通常处方剂量。所有四种降脂药均显着降低血清胆固醇水平，而不影响血压、踝肱指数或血清甘油三酯水平。三个他汀类药物组的 C 反应蛋白血清水平显着下降，但非他汀类药物组则没有。这些结果表明，高脂血症高血压患者长期使用氟伐他汀可显着降低主动脉僵硬度，但对血压没有任何影响。
Although lowering blood pressure ( BP) reduces aortic stiffness, achieving the recommended BP goal can be difficult. Recent studies have shown that short-term use of statins can reduce BP significantly. To determine the long-term effects of statins on BP and aortic stiffness, a single-blind randomized prospective study was performed on 85 hyperlipidaemic hypertensive patients whose BP was insufficiently controlled by antihypertensive therapy. Every 3 months, aortic stiffness was assessed by measuring pulse wave velocity (PWV). Patients were randomly allocated to groups treated with pravastatin, simvastatin, fluvastatin, or a nonstatin antihyperlipidaemic drug. No significant differences in patient characteristics, kinds of antihypertensive drugs, BP, ankle brachial index, PWV, or serum lipid, creatinine, or C-reactive protein levels were found between the four groups at the start of the study. During the 12-month treatment period, PWV did not change in the pravastatin group or nonstatin group, but it was transiently reduced in the simvastatin group and significantly decreased in the fluvastatin group, even though the doses of the statins used in this study were lower than the usually prescribed dose. All four antihyperlipidaemic drugs significantly decreased serum cholesterol levels without affecting BP, ankle brachial index, or serum triglyceride levels. The C-reactive protein serum levels decreased significantly in the three statin groups but not in the nonstatin group. These results suggest that long-term use of fluvastatin by hyperlipidaemic hypertensive patients is associated with a significant reduction in aortic stiffness without any effect on BP.