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Statin's role on blood pressure levels: Meta-analysis based on randomized controlled trials
Hui Ting Liu1, Nian Hua Deng1, Ze Fan Wu1
1Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerosis of Hunan Province, Hengyang Medical College, University of South China, Hengyang, Hunan, PR China.
Insights
Statins may slightly lower blood pressure (BP), with a small but statistically significant reduction observed in systolic and diastolic BP. Further large-scale studies are needed to confirm these findings and their clinical significance.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Statins are primarily used to reduce cardiovascular events.
- Their potential role in blood pressure (BP) management and as antihypertensives remains debated.
- This study investigates the BP-lowering effects of statins.
Approach:
- A comprehensive meta-analysis was conducted, searching major databases (Scopus, PubMed, Web of Science, Cochrane) from 2002-2022.
- Included randomized controlled trials (RCTs) examining statin effects on BP in normotensive and hypertensive individuals.
- Analyzed changes in systolic and diastolic BP as primary outcomes.
Key Points:
- The meta-analysis included 49 RCTs with 45,173 participants.
- A statistically significant reduction in systolic BP (ΔSBP = -1.42 mmHg) and diastolic BP (ΔDBP = -0.82 mmHg) was observed.
- While significant, the magnitude of BP reduction was modest.
Conclusions:
- Statins demonstrated a statistically significant, albeit small, effect on lowering both systolic and diastolic blood pressure.
- The clinical significance of this modest BP reduction warrants further investigation.
- Larger, long-term, multi-center, and multi-ethnic studies are recommended to definitively establish statins' antihypertensive potential.
Abstract:
Statins have been proven to be effective in minimizing the risk of cardiovascular adverse events, however, their effect on BP variability is debatable with respect to their significance and their use as a potential anti-hypertensive. Using a meta-analysis approach, the aim of this study was to explore whether certain statins have the potential to lower blood pressure (BP). For the period 2002-2022, Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched for the studies that examined the effect of statins on blood pressure in normotensive or hypertensive individuals. Randomized controlled clinical trials that investigated this effect were included based on our inclusion criteria. Our primary outcomes were changes in systolic and diastolic blood pressure (DBP). The final analysis of the study included 49 RCTs involving 45 173 participants randomized to receive either statins or placebo. Among the two groups, the total weighted mean difference (WMD) for systolic blood pressure (ΔSBP) was -1.42 (95% CI: -2.38, -0.46; p = .004) and diastolic blood pressure (ΔDBP) was 0.82 (95% CI: -1.28, -0.36; p = .0005). Despite various studies suggesting the efficacy of statins in blood pressure lowering to be significant and non-significant both, we observed a decrease in SBP and DBP both, although the change was not as large and could be considered significant. A large multicenter, multi-ethnic, large sample pool size, and a long period follow-up study is still required to assert these claims.
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