TY - JOUR
T1 - Statins, antihypertensive treatment, and blood pressure control in clinic and over 24 hours
T2 - Evidence from PHYLLIS randomised double blind trial
AU - Mancia, Giuseppe
AU - Parati, Gianfranco
AU - Revera, Miriam
AU - Bilo, Grzegorz
AU - Giuliano, Andrea
AU - Veglia, Fabrizio
AU - Crepaldi, Gaetano
AU - Zanchetti, Alberto
PY - 2010/4/17
Y1 - 2010/4/17
N2 - Objective: To investigate the possibility that statins reduce blood pressure as well as cholesterol concentrations through clinic and 24 hour ambulatory blood pressure monitoring. Design: Randomised placebo controlled double blind trial. Setting: 13 hospitals in Italy Participants: 508 patients with mild hypertension and hypercholesterolaemia, aged 45 to 70 years. Intervention: Participants were randomised to antihypertensive treatment (hydrochlorothiazide 25 mg once daily or fosinopril 20 mg once daily) with or without the addition of a statin (pravastatin 40 mg once daily). Main outcome measures: Clinic and ambulatory blood pressure measured every year throughout an average 2. 6 year treatment period. Results: Both the group receiving antihypertensive treatment without pravastatin (n=254) (with little change in total cholesterol) and the group receiving antihypertensive treatment with pravastatin (n=253) (with marked and sustained reduction in total cholesterol and low density lipoprotein cholesterol) had a clear cut sustained reduction in clinic measured systolic and diastolic blood pressure as well as in 24 hour, and day and night, systolic and diastolic blood pressure. Pravastatin performed slightly worse than placebo, and between group differences did not exceed 1.9 (95% confidence interval -0.6 to 4.3, P=0.13) mm Hg throughout the treatment period. This was also the case when participants who remained on monotherapy with hydrochlorothiazide or fosinopril throughout the study were considered separately. Conclusions: Administration of a statin in hypertensive patients in whom blood pressure is effectively reduced by concomitant antihypertensive treatment does not have an additional blood pressure lowering effect. Trial registration: BRISQUI-*IV-2004-001 (registered at Osservatorio Nazionale sulla Sperimentazione Clinica dei Medicinali - National Monitoring Centre on Clinical Research with Medicines).
AB - Objective: To investigate the possibility that statins reduce blood pressure as well as cholesterol concentrations through clinic and 24 hour ambulatory blood pressure monitoring. Design: Randomised placebo controlled double blind trial. Setting: 13 hospitals in Italy Participants: 508 patients with mild hypertension and hypercholesterolaemia, aged 45 to 70 years. Intervention: Participants were randomised to antihypertensive treatment (hydrochlorothiazide 25 mg once daily or fosinopril 20 mg once daily) with or without the addition of a statin (pravastatin 40 mg once daily). Main outcome measures: Clinic and ambulatory blood pressure measured every year throughout an average 2. 6 year treatment period. Results: Both the group receiving antihypertensive treatment without pravastatin (n=254) (with little change in total cholesterol) and the group receiving antihypertensive treatment with pravastatin (n=253) (with marked and sustained reduction in total cholesterol and low density lipoprotein cholesterol) had a clear cut sustained reduction in clinic measured systolic and diastolic blood pressure as well as in 24 hour, and day and night, systolic and diastolic blood pressure. Pravastatin performed slightly worse than placebo, and between group differences did not exceed 1.9 (95% confidence interval -0.6 to 4.3, P=0.13) mm Hg throughout the treatment period. This was also the case when participants who remained on monotherapy with hydrochlorothiazide or fosinopril throughout the study were considered separately. Conclusions: Administration of a statin in hypertensive patients in whom blood pressure is effectively reduced by concomitant antihypertensive treatment does not have an additional blood pressure lowering effect. Trial registration: BRISQUI-*IV-2004-001 (registered at Osservatorio Nazionale sulla Sperimentazione Clinica dei Medicinali - National Monitoring Centre on Clinical Research with Medicines).
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U2 - 10.1136/bmj.c1197
DO - 10.1136/bmj.c1197
M3 - Article
C2 - 20339154
AN - SCOPUS:77951073910
VL - 340
SP - 846
JO - British Medical Journal
JF - British Medical Journal
SN - 0959-8146
IS - 7751
M1 - c1197
ER -