Effect of pravastatin on blood pressure in people with cardiovascular disease

M. Tonelli, F. Sacks, M. Pfeffer, Francisco Lopez-Jimenez, G. S. Jhangri, G. Curhan

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Experimental evidence and several small studies in humans suggest that HMG-CoA (3-hydroxy 3-methylglutaryl coenzyme A) reductase inhibitors (statins) reduce blood pressure, perhaps through effects on endothelial function or by reducing inflammation. We tested the hypothesis that pravastatin would reduce blood pressure at 3 months and the risk of developing new hypertension over a follow-up period of 5 years. This was a post hoc subgroup analysis of a randomized double-blind placebo-controlled trial of pravastatin 40 mg daily vs placebo in 4159 participants with previous myocardial infarction and total plasma cholesterol <240 mg/dl (6.2 mmol/l). The primary outcome was the unadjusted change in mean arterial pressure (MAP) from baseline to 3 months. We also considered systolic and diastolic blood pressure (SBP and DBP) and pulse pressure. Analysis of covariance was used to calculate the adjusted effect of treatment on change in these outcomes at 3, 6, 12 and 24 months postrandomization, after controlling for potential confounders. Logistic regression was used to calculate the adjusted effect of treatment on incident hypertension (blood pressure ≥140/90 in those without known hypertension at baseline). This analysis included 4126/4159 (99.2%) participants for whom blood pressure was measured at baseline and during at least one follow-up visit. Median duration of follow-up was 57.8 months. The unadjusted and adjusted change in MAP, SBP, DBP or pulse pressure from baseline was not significantly different for pravastatin or placebo recipients at 3, 6, 12 or 24 months after randomization, or at last follow-up. Pravastatin did not reduce the adjusted risk of incident systolic hypertension (odds ratio 0.99, 95% CI 0.80-1.23), or incident diastolic hypertension (odds ratio 0.97, 95% CI 0.73-1.27). In summary, pravastatin 40 mg daily did not reduce blood pressure in survivors of myocardial infarction without overt hypercholesterolaemia.

Original languageEnglish (US)
Pages (from-to)560-565
Number of pages6
JournalJournal of Human Hypertension
Volume20
Issue number8
DOIs
StatePublished - Aug 2006

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Pravastatin
Cardiovascular Diseases
Blood Pressure
Hypertension
Placebos
Arterial Pressure
Odds Ratio
Myocardial Infarction
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Random Allocation
Hypercholesterolemia
Oxidoreductases
Logistic Models
Cholesterol
Inflammation

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Effect of pravastatin on blood pressure in people with cardiovascular disease. / Tonelli, M.; Sacks, F.; Pfeffer, M.; Lopez-Jimenez, Francisco; Jhangri, G. S.; Curhan, G.

In: Journal of Human Hypertension, Vol. 20, No. 8, 08.2006, p. 560-565.

Research output: Contribution to journalArticle

Tonelli, M. ; Sacks, F. ; Pfeffer, M. ; Lopez-Jimenez, Francisco ; Jhangri, G. S. ; Curhan, G. / Effect of pravastatin on blood pressure in people with cardiovascular disease. In: Journal of Human Hypertension. 2006 ; Vol. 20, No. 8. pp. 560-565.
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