Statins, antihypertensive treatment, and blood pressure control in clinic and over 24 hours: evidence from PHYLLIS randomised double blind trial
Abstract
Objective
To investigate the possibility that statins reduce blood pressure as
well as cholesterol concentrations through clinic and 24 hour ambulatory
blood pressure monitoring.
Design Randomised placebo controlled double blind trial.
Setting 13 hospitals in Italy
Participants 508 patients with mild hypertension and hypercholesterolaemia, aged 45 to 70 years.
Intervention
Participants were randomised to antihypertensive treatment
(hydrochlorothiazide 25 mg once daily or fosinopril 20 mg once daily)
with or without the addition of a statin (pravastatin 40 mg once daily).
Main outcome measures Clinic and ambulatory blood pressure measured every year throughout an average 2.6 year treatment period.
Results
Both the group receiving antihypertensive treatment without pravastatin
(n=254) (with little change in total cholesterol) and the group
receiving antihypertensive treatment with pravastatin (n=253) (with
marked and sustained reduction in total cholesterol and low density
lipoprotein cholesterol) had a clear cut sustained reduction in clinic
measured systolic and diastolic blood pressure as well as in 24 hour,
and day and night, systolic and diastolic blood pressure. Pravastatin
performed slightly worse than placebo, and between group differences did
not exceed 1.9 (95% confidence interval −0.6 to 4.3, P=0.13) mm Hg
throughout the treatment period. This was also the case when
participants who remained on monotherapy with hydrochlorothiazide or
fosinopril throughout the study were considered separately.
Conclusions
Administration of a statin in hypertensive patients in whom blood
pressure is effectively reduced by concomitant antihypertensive
treatment does not have an additional blood pressure lowering effect.
Trial registration
BRISQUI_*IV_2004_001 (registered at Osservatorio Nazionale sulla
Sperimentazione Clinica dei Medicinali—National Monitoring Centre on
Clinical Research with Medicines).
Edited from bmj.com
Picture from drjohnlapuma.com
#statins #antihypertensive
