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(Hypertension. 2007;50:e13.)
© 2007 American Heart Association, Inc.

Letters to the Editor

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

Department of Clinical & Experimental Medicine, Federico II University of Naples,, Naples, Italy

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

Cereda and Pietrobelli wrote that the occurrence of overweight or obesity in at least a portion of the patients included in our metaanalysis may have affected our end point or at least contributed to the heterogeneity of our study results.¹ Although this is a reasonable contention, a careful evaluation of the trials included in the metaanalysis showed that, in the majority of cases, either no significant body weight change was observed during the study or the changes reported were comparable in the groups receiving statin and control treatment, respectively.² In fact, both in the study by De Rosa et al,³ which involved obese patients, and in the one by Bak and coworkers,⁴ which included overweight individuals with prescription of weight reducing diets, the changes actually observed in body weight as an effect of intervention were similar in patients receiving statin therapy and in those who did not. In a few other studies, no mention was made of changes in body weight or other anthropometric parameter.

Cereda and Pietrobelli also raised the point that obesity per se, even in the absence of glucose intolerance or diabetes, may be associated with endothelial dysfunction⁵ and that this may be favorably affected by a healthier diet or reduction of overweight. We do agree with this view, but again it seems unlikely that this occurrence may explain our results as these alterations affected actively treated and control patients to a similar extent.

In any case, we share the concept that a carefully controlled randomized trial . . . [Full Text of this Article]