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Published on: November 10, 2017
Use of statins and blood pressure
Dana E King1, Arch G Mainous, Brent M Egan
1Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. kingde@musc.edu
Insights
Statin use was linked to better blood pressure control in hypertensive adults. Inflammation markers like C-reactive protein did not explain this association, suggesting statins may directly benefit blood pressure management.
Area of Science:
- Cardiovascular Health
- Pharmacology
- Public Health
Background:
- Hypertension is linked to elevated inflammation markers, including C-reactive protein (CRP).
- Previous small trials indicated statin therapy might reduce blood pressure (BP).
- The association between statin use and BP control in larger populations remains unclear.
Purpose of the Study:
- To investigate the association between statin use and blood pressure control in a large sample of hypertensive adults.
- To determine if inflammation levels, specifically CRP, mediate the relationship between statin use and BP control.
Main Methods:
- Cross-sectional analysis of 2584 hypertensive adults (aged >=40) from the 1999-2002 National Health and Nutrition Examination Survey.
- Logistic regression models were employed to assess the association between statin use and BP control (<140/90 mm Hg).
- The impact of C-reactive protein (CRP) on this association was evaluated by including it in the regression models.
Main Results:
- Statin users demonstrated significantly better blood pressure control (52.2%) compared to non-users (38.0%).
- Statin users were twice as likely to achieve controlled blood pressure, even after adjusting for demographic and lifestyle factors (OR=1.46, 95% CI: 1.05-2.05).
- The beneficial association was most pronounced in patients using both statins and antihypertensive medications and was not affected by CRP levels.
Conclusions:
- Statin use is independently associated with achieving blood pressure levels below 140/90 mm Hg in US adults with hypertension.
- Inflammation markers (CRP) do not appear to mediate the relationship between statin use and improved blood pressure control.
- Further research is warranted to elucidate the mechanisms and clinical applications of statins in managing hypertension.
Background:
Markers of inflammation such as high-sensitivity C-reactive protein (CRP) were shown to be elevated in patients with hypertension. Small trials using statin therapy showed blood-pressure (BP) reductions, but it is unknown whether this association extends to larger populations. The objective of this study was to determine whether statin use was associated with better blood-pressure control in adults with hypertension and whether inflammation levels mediated this relationship.
Methods:
This was a cross-sectional study of 2584 hypertensive adults aged >or=40 years with no known cardiovascular disease from the National Health and Nutrition Examination Survey 1999-2002. Logistic regression models were calculated to determine whether there was an association between statin use and blood-pressure control. C-reactive protein was added to the full model to determine its impact on the association.
Results:
Compared with people not using statin medication, significantly more statin users had their blood pressure under control (52.2% v 38.0%). After adjustment for demographic factors, statin users were two times (95% confidence interval [CI], 1.46 to 2.72) more likely to have their blood pressure under control (<140/90 mm Hg) than nonusers. After further adjustment for body mass index, diabetes, smoking, exercise, low-salt diet, and antihypertensive medications, the likelihood of having blood pressure under control remained more likely among statin users (odds ratio, 1.46; 95% CI, 1.05 to 2.05). The association between statin use and lower BP was most evident among participants who used antihypertensive medication as well as statins and was unchanged with the addition of CRP to the model.
Conclusions:
Statin use was associated with a BP level <140/90 mm Hg in a representative sample of US adults with hypertension. Levels of CRP did not attenuate the association. Further studies are needed to explore the effects of statin use on blood pressure and to determine how best to apply this knowledge in clinical care.
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