Statins in Hypertension
Pp. 1-11 (11)
Carlos A. Feldstein
Hypertension is highly prevalent in industrialized countries. Older age is associated with more uncontrolled hypertension New developments to reinforce antihypertensive drug effects include the use of statins. The beneficial effects of statins that are partly independent of their lipid-lowering actions are referred to as pleiotropic effects. These effects include the improvement of vascular endothelial function, inhibition of vascular smooth muscle cell prolife-ration and migration, anti-inflammatory actions, anti-oxidative effects or stabilization of vulnerable plaques, and enhancement of arterial compliance. So far, the available data support only a modest antihypertensive effect of statins that is most prominent in those patients with uncontrolled hypertension. Even though they only produce minor reduction in blood pressure, their effects may be relevant from the point of view of cardiovascular prevention. From trials results it appears consistent that statins may be useful in hypertensive subjects with high serum total cholesterol, in those whose hypertension is not well controlled with antihypertensive agents even without high serum total cholesterol, in hypertensive subjects well controlled with antihypertensives without high serum cholesterol when they have high PCR levels, in those with other concomitant cardiovascular risk factors, or when they require secondary prevention. Future research could further characterize the impact of statin use alone or in combination with antihypertensive agents to prevent the development of stage 1 hypertension in prehypertension.
Statins, hypertension treatment
Hypertension Program, Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina