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(Hypertension. 2007;49:792.)
© 2007 American Heart Association, Inc.

Original Articles

Do Statins Reduce Blood Pressure?

A Meta-Analysis of Randomized, Controlled Trials

Pasquale Strazzullo; Sally M. Kerry; Antonio Barbato; Marco Versiero; Lanfranco D’Elia; Francesco P. Cappuccio

From the Department of Clinical and Experimental Medicine (P.S., A.B., M.V., L.D.), Federico II University Medical School, Naples, Italy; the Division of Community Health Sciences (S.M.K.), St George’s, University of London, London, United Kingdom; and the Clinical Sciences Research Institute (F.P.C.), Warwick Medical School, Coventry, United Kingdom.

Correspondence to Pasquale Strazzullo, Department of Clinical and Experimental Medicine, "Federico II" University of Naples Medical School, Via S. Pansini, 5, 80131 Naples, Italy. E-mail strazzul{at}unina.it

A meta-analysis was performed of the effect of 3hydroxy3methylglutaryl-coenzyme A reductase inhibitors (statins) on blood pressure in humans including the randomized, controlled trials of statin therapy (20 trials and 828 patients) in which concomitant antihypertensive treatment (if any) remained unchanged throughout the study. A total of 291 and 272 patients were given a statin or placebo, respectively, in parallel group trials, whereas 265 took part in crossover trials receiving a statin and placebo (or probucol, in 1 trial). Systolic blood pressure was significantly lower in patients on statin than in those on placebo or control hypolipidemic drug (mean difference: –1.9 mm Hg; 95% CI: –3.8 to –0.1). The effect was greater when the analysis was restricted to studies with a baseline systolic blood pressure >130 mm Hg ( systolic blood pressure: –4.0; 95% CI: –5.8 to –2.2 mm Hg). There was a trend for lower diastolic blood pressure in patients receiving statin therapy compared with control: –0.9 mm Hg (95% CI: –2.0 to 0.2) overall and –1.2 mm Hg (95% CI: –2.6 to 0.1) in studies with a baseline diastolic blood pressure >80 mm Hg. In general, the higher the baseline blood pressure, the greater the effect of statins on blood pressure (P=0.066 for systolic blood pressure and P=0.023 for diastolic blood pressure). The blood pressure response to statins was unrelated to age, changes in serum cholesterol, or length of the trial. In conclusion, statin therapy has a relatively small but statistically significant and clinically meaningful effect on blood pressure.

Key Words: blood pressure • hypertension, arterial • hypercholesterolemia • drug therapy • statins • meta-analysis

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