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(Hypertension. 2007;50:e12.)
© 2007 American Heart Association, Inc.

Letters to the Editor

Statins and Blood Pressure Lowering: A Claim for Ad-Hoc Trials

International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy

Angelo Pietrobelli

Pediatric Unit, Verona University Medical School, Verona, Italy

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

An interesting meta-analysis on the blood pressure–lowering effect of statins was recently been published in Hypertension.¹ To obtain results of clinical significance, Strazzullo et al have performed a difficult and laborious review of randomized trials with rigid and very strict inclusion and exclusion criteria. Although there were limitations related to small sample size, inadequacy of previous study designs, heterogeneity of patients, therapies, duration of the trials, and statistical analyses, these limitations have been discussed by the authors. In addition, the most important beneficial vascular pleiotropic effects of statins have been considered and evidence that a clinically meaningful gain is achievable from their use has been provided.¹

In agreement with the conclusions reached, we want to add some further possible limitations to the analysis that might be taken into account when planning future studies.

The trials considered in the metaanalysis included both overweight and obese patients/subjects. In addition, although the heterogeneity of dietary treatments has been carefully reviewed and exhaustively described, there was no possibility to investigate its role. However, no mention in the discussion has been provided with this regard.¹ In some cases, diet-induced weight loss occurred, whereas in others no information on final body weight or BMI was available. Moreover, significant weight loss has been considered an important cause of blood pressure lowering (please see referenced trials included in the meta-analysis¹).

If endothelial dysfunction represents an abnormality of hypercholesterolemic patients, obesity per se, in particular visceral adiposity, is independently associated with both² and also . . . [Full Text of this Article]

This article has been cited by other articles:

				P. Strazzullo and A. Barbato Response to Statins and Blood Pressure Lowering: A Claim for Ad-Hoc Trials Hypertension, August 1, 2007; 50(2): e13 - e13. [Full Text] [PDF]