Background We studied the effect of statin therapy (simvastatin or pravastatin) on office blood pressure and 24﷓hour blood pressure pattern in patients with essential arterial hypertension and hypercholesterolemia, taking antihypertensive drugs.
Material and methods The study was in 23 patients (pts), women: 13, men: 10, age 50–72 (mean 60,2), with chronic arterial hypertension. Treatment: indapamid 1,5 mg a day, enalapril 20-40 mg a day. Patients with basal total cholesterol (TC) 6,5-10,0 mmol/l, LDL cholesterol (LDL-C) > > 4,1 mmol/l and triglyceride (TG) < 3,5 mmol/l were included. After 6 week run-in period and hypolipemic diet therapy patients were divided in two groups: the I group-included 11 pts treated with simvastatin 10-20 mg a day for 12 weeks. In the II group - 12 pts were given pravastatin 10-20 mg a day for 3 months. Blood pressure was measured with the traditional method (standardised mercurial manometers) every 6 weeks. After 6 weeks of treatment because of a higher cholesterol values, the dose increase was required (from 10 mg to 20 mg) in 2 patients of 11 treated with simvastatin and 3 of 12 trated with pravastatin. After the placebo period, and after 6 and 12 weeks of treatment with statins 24-hour ambulatory blood pressure measurements (ABPM) were performed with Spacelab 90207 recorder.
Results In both 6-week and 12-week simvastatin treatment periods, statistically significant reduction of systolic blood pressure (SBP) measured by standard method, as compared to the placebo period was observed {135 ± 3,2 mm Hg ® ® 121,1 ± 13,1 mm Hg (p < 0,05) ® 116,2 ± 1,4 mm Hg (p < 0,01) on placebo and after 6 and 12 weeks of simvastatin, respectively}. In the same group of patients and period given diastolic blood pressure values tended to decrease 83 ± 2,2 ® 80,5 ± 2,8 mm Hg. After 3 months to follow-up in ABPM we observed only a tendency to decrease values of blood pressure. We observed a greater reduction of SBP and DBP values during the day than during the night. In pravastatin group the BP was not lowered significantly.
Conclusion The result of this study demonstrate that the use of simvastatin in combination with antihypertensive drugs, unlike pravastatin, can reduce the level of SBP providing adequate control of hypertension and cholesterol levels.