Association between different lipid-lowering treatment strategies and blood pressure control in the Brisighella Heart Study

• Published in: The American heart journal 2004-08, Vol.148 (2), p.285-292
• Main Authors: Borghi, Claudio, Dormi, Ada, Veronesi, Maddalena, Sangiorgi, Zina, Gaddi, Antonio
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Anticholesteremic Agents - pharmacology; Anticholesteremic Agents - therapeutic use; Antihypertensive Agents - therapeutic use; Atherosclerosis; Biological and medical sciences; Blood Pressure - drug effects; Cardiology. Vascular system; Cardiovascular disease; Cholesterol; Cholesterol, LDL - blood; Cholestyramine Resin - pharmacology; Cholestyramine Resin - therapeutic use; Colleges & universities; Drug therapy; Female; Gemfibrozil - pharmacology; Gemfibrozil - therapeutic use; Heart; Heart attacks; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia - complications; Hypercholesterolemia - diet therapy; Hypercholesterolemia - drug therapy; Hypertension; Hypertension - complications; Hypertension - drug therapy; Hypertension - physiopathology; Lipids; Lipoproteins; Male; Medical sciences; Middle Aged; Mortality; Older people; Population; Prospective Studies; Simvastatin - pharmacology; Simvastatin - therapeutic use; Statins; Statistical analysis; Variance analysis
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2004.02.003

Small studies have suggested that lipid-lowering strategies, and particularly statins, could influence blood pressure (BP) control. The aim of the present study was to evaluate the effect of different lipid-lowering strategies on BP control of subjects with hypercholesterolemia who were enrolled in the prospective, population-based, longitudinal Brisighella Heart Study. A total of 1356 subjects with total cholesterol levels ≥239 mg/dL were randomly treated for 5 years (1988–1993) with 1 of these lipid-lowering regimens: low-fat diet, cholestyramine, gemfibrozil, or simvastatin. Participants were divided at baseline into 4 quartiles according to systolic BP level and examined for the percent change in systolic and diastolic BP during the 5 years of treatment. A significant decrease in BP was observed in the 2 upper quartiles of systolic BP (≥140 mm Hg) and was greater in subjects treated with cholesterol-lowering drugs who also had a greater reduction in plasma levels of low-density lipoprotein cholesterol. The BP decrease was greater in patients treated with statin drugs and, among those treated with antihypertensive drugs, in subjects in the fourth quartile. The use of lipid-lowering measures could significantly improve BP control in subjects with both hypercholesterolemia and hypertension. The reduction in BP seems to be enhanced in subjects treated with statins.