1
|
Khan Z, Gul A, Mlawa G, Bhattacharjee P, Muhammad SA, Carpio J, Yera H, Wahinya M, Kazeza AP, Amin MS, Gupta A. Statins As Anti-Hypertensive Therapy: A Systematic Review and Meta-Analysis. Cureus 2024. [DOI: 10.7759/cureus.57825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
|
2
|
Abebe RB, Kebede SA, Birarra MK. The association of lipid-lowering therapy and blood pressure control among outpatients with hypertension at the Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia. Front Cardiovasc Med 2023; 10:1071338. [PMID: 36937906 PMCID: PMC10014929 DOI: 10.3389/fcvm.2023.1071338] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/02/2023] [Indexed: 03/05/2023] Open
Abstract
Background The lipid-lowering medications known as statins have been shown in controlled clinical trials to have pleiotropic properties, such as lowering blood pressure, in addition to lowering cholesterol levels. The purpose of this study was to see if there was a possible link between blood pressure control and statin therapy in outpatients with hypertension in a real clinical setting. Patients and methods A retrospective comparative cohort study of 404 patients with hypertension was carried out. A systematic random sampling technique was used. For data entry, Epi-Data version 4.6 was used, and SPSS version 25 was used for further analysis. For group comparisons, chi-square and independent t-tests were computed. To determine the relationship between statin use and blood pressure control, a binary logistic regression model was employed. To declare statistical significance, a 95% confidence interval and a P-value of <0.05 were used. Results Half of the study participants who were using a prescribed statin were assigned to the statin group, whereas the remaining participants who do not take statins were assigned to the control group. After 3 months of statin treatment, BP control to <130/80 mmHg was significantly greater (P = 0.022) in the statin group (52.5%) than in the control group (41.0%). The use of statins raises the likelihood of having blood pressure under control by 1.58 times when compared to statin non-users. After controlling for possible confounders, statin therapy still increased the odds of having controlled BP by a factor of 5.98 [OR = 5.98; 95% CI: 2.77-12.92]. Conclusion This study revealed that blood pressure control was higher among statin user hypertensive patients. Favorable effects of statin use were independently observed, even after correction for age, presence of dyslipidemia, and duration of antihypertensive therapy. Therefore, the importance of concomitantly added lipid-lowering drugs such as statins and their role in managing poor blood pressure control should be given due emphasis.
Collapse
Affiliation(s)
- Rahel Belete Abebe
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Rahel Belete Abebe
| | - Sewnet Adem Kebede
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mequanent Kassa Birarra
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
3
|
Alghamdi J, Alqadi A, Alharf A, Almuzzaini B, Mahmud A, Barhoumi T, Badreldin HA, Alaamery M, Padmanabhan S. Blood pressure–lowering activity of statins: a systematic literature review and meta-analysis of placebo-randomized controlled trials. Eur J Clin Pharmacol 2020; 76:1745-1754. [DOI: 10.1007/s00228-020-02965-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/16/2020] [Indexed: 01/28/2023]
|
4
|
Factors associated with increase in blood pressure and incident hypertension in early midlife: the Hordaland Health Study. Blood Press 2020; 29:267-275. [DOI: 10.1080/08037051.2020.1762070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
5
|
Kim W, Chang K, Cho EJ, Ahn J, Yu CW, Cho K, Kim Y, Kang D, Kim S, Lee S, Kim U, Kim S, Ahn YK, Lee CH, Shin JH, Kim M, Park CG. A randomized, double‐blind clinical trial to evaluate the efficacy and safety of a fixed‐dose combination of amlodipine/rosuvastatin in patients with dyslipidemia and hypertension. J Clin Hypertens (Greenwich) 2020; 22:261-269. [DOI: 10.1111/jch.13774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/04/2019] [Accepted: 11/04/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Woohyeun Kim
- Cardiovascular Center Korea University Guro Hospital Seoul Korea
| | - Kiyuk Chang
- Division of Cardiology Seoul St. Mary's Hospital Seoul Korea
| | - Eun Joo Cho
- Division of Cardiology St. Paul's Hospital Seoul Korea
| | - Jeong‐Cheon Ahn
- Division of Cardiology Korea University Ansan Hospital Ansan Korea
| | - Cheol Woong Yu
- Division of Cardiology Korea University Anam Hospital Seoul Korea
| | - Kyoung‐Im Cho
- Division of Cardiology Maryknoll Medical Center Busan Korea
| | - Yong‐Jin Kim
- Cardiovascular Center Seoul National University Hospital Seoul Korea
| | - Duk‐Hyun Kang
- Valvular Heart Disease Center Asan Medical Center Heart Institute Seoul Korea
| | - Seok‐Yeon Kim
- Department of Cardiology Seoul Medical Center Seoul Korea
| | - Sang‐Hak Lee
- Division of Cardiology Severance Cardiovascular Hospital Seoul Korea
| | - Ung Kim
- Division of Cardiology Yeungnam University Medical Center Daegu Korea
| | - Shin‐Jae Kim
- Division of Cardiology Ulsan University Hospital Ulsan Korea
| | - Young Keun Ahn
- Heart Center of Chonnam National University Hospital Gwangju Korea
| | - Chang Hoon Lee
- Division of Cardiology Veterans Health Service Medical Center Seoul Korea
| | - Jin Ho Shin
- Division of Cardiology Hanyang University Hospital Seoul Korea
| | - Mikyung Kim
- Yuhan Research Institute Yuhan Corporation Yongin Korea
| | - Chang Gyu Park
- Cardiovascular Center Korea University Guro Hospital Seoul Korea
| |
Collapse
|
6
|
Socha M, Pietrzak A, Grywalska E, Pietrzak D, Matosiuk D, Kiciński P, Rolinski J. The effect of statins on psoriasis severity: a meta-analysis of randomized clinical trials. Arch Med Sci 2020; 16:1-7. [PMID: 32051699 PMCID: PMC6963135 DOI: 10.5114/aoms.2019.90343] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/18/2019] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Statins may reduce the severity of psoriasis, but the available evidence is unclear. We conducted a meta-analysis of randomized controlled studies (RCTs) that investigated the effect of statins on psoriasis severity assessed with the Psoriasis Area and Severity Index (PASI). MATERIAL AND METHODS Two investigators searched independently the following databases: Medline, EMBASE, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov from inception to February 2019. Additionally, reference lists from all available articles were searched manually. We included only RCTs carried out among adult (≥ 16 years) patients with psoriasis who received oral statins for ≥ 8 weeks and had psoriasis severity assessed with the PASI at baseline and at the end of follow-up. We used random effects meta-analysis to calculate the mean difference (D) in PASI change between patients who received either a statin or a comparator. RESULTS Of 279 records identified, there were 5 eligible RCTs, with a total of 223 patients, including 128 patients who received a statin (atorvastatin or simvastatin). The improvement in psoriasis severity (PASI) was significantly greater in patients who received statins than in those who received comparators (D = 2.76, 95% CI: 0.49-5.04, p = 0.017). In subgroup analyses, the improvement in PASI values was significant for simvastatin (D = 3.70, 95% CI: 2.52-4.89, p < 0.001) but not for atorvastatin (D = 2.30, 95% CI: -1.28-5.88, p = 0.210). CONCLUSIONS Oral statins may improve psoriasis, particularly in patients with severe disease. This observation should be verified in long-term, well-designed studies that will enable analyses adjusted for clinical variables.
Collapse
Affiliation(s)
- Mateusz Socha
- Department of Internal Medicine and Cardiology, 1 Military Clinical Hospital, Lublin, Poland
| | - Aldona Pietrzak
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Ewelina Grywalska
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Lublin, Poland
| | - Daniel Pietrzak
- Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland
| | - Dariusz Matosiuk
- Department of Synthesis and Chemical Technology of Pharmaceutical Substances, Medical University of Lublin, Lublin, Poland
| | - Paweł Kiciński
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Jacek Rolinski
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Lublin, Poland
| |
Collapse
|
7
|
Does Co-administration of Antihypertensive Drugs and Statins Alter Their Efficacy and Safety? A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Cardiovasc Pharmacol 2019; 73:352-358. [DOI: 10.1097/fjc.0000000000000671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Del Pinto R, Ferri C, Borghi C. Letter by Del Pinto et al Regarding Article, "Prevention of Stroke With the Addition of Ezetimibe to Statin Therapy in Patients With Acute Coronary Syndrome in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial)". Circulation 2018; 137:2654-2655. [PMID: 29891621 DOI: 10.1161/circulationaha.117.032448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rita Del Pinto
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, Italy (R.D.P., C.F.).,Division of Internal Medicine & Nephrology, San Salvatore Hospital, L'Aquila, Italy (R.D.P., C.F.).,The Italian Society of Hypertension, Milan, Italy (R.D.P., C.F., C.B.)
| | - Claudio Ferri
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, Italy (R.D.P., C.F.).,Division of Internal Medicine & Nephrology, San Salvatore Hospital, L'Aquila, Italy (R.D.P., C.F.).,The Italian Society of Hypertension, Milan, Italy (R.D.P., C.F., C.B.)
| | - Claudio Borghi
- The Italian Society of Hypertension, Milan, Italy (R.D.P., C.F., C.B.).,Department of Medical and Surgical Sciences, Division of Internal Medicine, Alma Mater Studiorum University of Bologna, Policlinico S. Orsola-Malpighi, Italy (C.B.)
| |
Collapse
|
9
|
Presta V, Figliuzzi I, Citoni B, Miceli F, Battistoni A, Musumeci MB, Coluccia R, De Biase L, Ferrucci A, Volpe M, Tocci G. Effects of different statin types and dosages on systolic/diastolic blood pressure: Retrospective analysis of 24-hour ambulatory blood pressure database. J Clin Hypertens (Greenwich) 2018; 20:967-975. [DOI: 10.1111/jch.13283] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/23/2018] [Accepted: 03/11/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Vivianne Presta
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
| | - Ilaria Figliuzzi
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
| | - Barbara Citoni
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
| | - Francesca Miceli
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
| | - Allegra Battistoni
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
| | - Maria Beatrice Musumeci
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
| | | | - Luciano De Biase
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
| | - Andrea Ferrucci
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
| | - Massimo Volpe
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
- IRCCS Neuromed; Pozzilli Italy
| | - Giuliano Tocci
- Division of Cardiology; Department of Clinical and Molecular Medicine; Faculty of Medicine and Psychology; Sant'Andrea Hospital; University of Rome Sapienza; Rome Italy
- IRCCS Neuromed; Pozzilli Italy
| |
Collapse
|
10
|
Otsuka T, Mizuno K, Shinozaki T, Kachi Y, Nakamura H. Preventive effect of pravastatin on the development of hypertension in patients with hypercholesterolemia: A post-hoc analysis of the Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study. J Clin Lipidol 2017; 11:998-1006. [PMID: 28655522 DOI: 10.1016/j.jacl.2017.05.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/22/2017] [Accepted: 05/23/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND It remains unclear whether treatment of dyslipidemia with 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) reduces the risk of developing hypertension. OBJECTIVE In this post-hoc analysis of the Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study, a large-scale primary prevention trial with pravastatin, we examined the preventive effect of pravastatin on the future development of hypertension in patients with hypercholesterolemia. METHODS Of the overall (MEGA) Study population, 3397 nonhypertensive patients at baseline were enrolled in this study. The patients were randomly assigned to either the diet alone group (n = 1722) or the diet plus pravastatin group (n = 1675) and then were followed-up for a median of 36 months to determine new-onset hypertension. RESULTS During the follow-up period, 1595 patients developed hypertension (49.1% in the diet alone group and 44.7% in the diet plus pravastatin group). After adjusting for multiple covariates, the diet plus pravastatin group showed a 10% reduction in the risk of developing hypertension (hazard ratio 0.90, 95% confidence interval 0.81-0.998), compared with the diet alone group. Subgroup analyses revealed that the preventive effect of pravastatin on the development of hypertension was pronounced in patients aged ≥60 years, men, those with chronic kidney disease or diabetes mellitus and those without obesity. CONCLUSIONS Pravastatin reduced the risk of developing hypertension in Japanese patients with hypercholesterolemia. The risk reduction of cardiovascular disease with statins could be partly explained by their preventive effect on the development of hypertension.
Collapse
Affiliation(s)
- Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan; Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan.
| | | | - Tomohiro Shinozaki
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Yuko Kachi
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| | | |
Collapse
|
11
|
You T, Liu XG, Hou XD, Wang XK, Xie HH, Ding F, Yi K, Zhang P, Xie XD. Effect of statins on blood pressure: Analysis on adverse events released by FDA. Clin Exp Hypertens 2017; 39:325-329. [PMID: 28513233 DOI: 10.1080/10641963.2016.1254224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE As a class of cholesterol-lowering drugs, statins have been reported to cause unexpected decrease in blood pressure (BP). However, most studies in this issue were subject to inadequate study design or very small sample size. The present study was designed to examine the BP-lowering effect of various statins. METHODS Here we retrieved 5.9 million clinical reports submitted to FDA Adverse Event Reporting System (FAERS) from 2004 to 2015. Meta-analysis was performed to estimate the overall reporting odds ratio (ROR) of hypotension adverse events concurrent with various statins (i.e., atorvastatin, simvastatin, and rosuvastatin). RESULTS Comparing the reporting rate of hypotension event between statins and other drugs found that atorvastatin (pooled ROR = 1.26, adjusted p-value = 8.60 × 10-4) and simvastatin (pooled ROR = 1.94, adjusted p-value = 4.16 × 10-45) were significantly associated with reduction in BP. On the other hand, the association between rosuvastatin and hypotension was observed to be nonsignificant (adjusted p-value = 0.65). CONCLUSION To our knowledge, this is the first pooled analysis on large-scale data of adverse events to identify the BP-lowering effect of statins. The results will contribute to the development of novel statin-based antihypertensive therapies. In addition, the differential effects of individual statins can warrant subsequent research on the underlying mechanisms of BP control.
Collapse
Affiliation(s)
- Tao You
- a Department of Cardiovascular , Surgery of Gansu Provincial Hospital , Lanzhou City , Gansu Province , China
| | - Xing-Guang Liu
- a Department of Cardiovascular , Surgery of Gansu Provincial Hospital , Lanzhou City , Gansu Province , China
| | - Xiao-Dong Hou
- a Department of Cardiovascular , Surgery of Gansu Provincial Hospital , Lanzhou City , Gansu Province , China
| | - Xin-Kuan Wang
- a Department of Cardiovascular , Surgery of Gansu Provincial Hospital , Lanzhou City , Gansu Province , China
| | - Han-Hui Xie
- b School of Basic Medical Science , Lanzhou University , Lanzhou City , Gansu Province , China
| | - Fan Ding
- a Department of Cardiovascular , Surgery of Gansu Provincial Hospital , Lanzhou City , Gansu Province , China
| | - Kang Yi
- a Department of Cardiovascular , Surgery of Gansu Provincial Hospital , Lanzhou City , Gansu Province , China
| | - Peng Zhang
- a Department of Cardiovascular , Surgery of Gansu Provincial Hospital , Lanzhou City , Gansu Province , China
| | - Xiao-Dong Xie
- b School of Basic Medical Science , Lanzhou University , Lanzhou City , Gansu Province , China
| |
Collapse
|
12
|
Borghi C, Urso R, Cicero AF. Renin-angiotensin system at the crossroad of hypertension and hypercholesterolemia. Nutr Metab Cardiovasc Dis 2017; 27:115-120. [PMID: 27745933 DOI: 10.1016/j.numecd.2016.07.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/30/2016] [Accepted: 07/31/2016] [Indexed: 01/24/2023]
Abstract
AIM The aim of this study is to discuss the reliable scientific evidence of an interactive link between hypertension and hypercholesterolemia considering the metabolic pathways and the pathogenetic mechanisms connecting the two risk factors. DATA SYNTHESIS Hypertension and hypercholesterolemia are highly prevalent in the general population and their coexistence in the same subjects additively increases the risk of cardiovascular disease. Probably, hypercholesterolemia is also a risk factor for the development of hypertension. On the other side, it is also possible that lipid-lowering treatment could improve blood pressure control. Although the mechanisms of interaction between these two risk factors have not been completely elucidated thus far, there is rapidly growing evidence that the involvement of the renin-angiotensin system (RAS) can be considered as the common link between hypertension and hypercholesterolemia. In particular, hypercholesterolemia seems to promote the upregulation of type 1 angiotensin II (AT1) receptor genes because of an increase in the stability of mRNA followed by structural overexpression of vascular AT1 receptors for angiotensin II. The treatment of both risk factors greatly improves individual risk profile, especially when statins and RAS blockers are used together. CONCLUSIONS Hypertension and hypercholesterolemia are highly coprevalent and strongly related from a pathophysiological point of view. The RAS could be the main mediator of this link.
Collapse
Affiliation(s)
- C Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - R Urso
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - A F Cicero
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|
13
|
Chang YY, Wu YW, Lee JK, Lin YM, Lin YT, Kao HL, Hung CS, Lin HJ, Lin YH. Effects of 12 weeks of atorvastatin therapy on myocardial fibrosis and circulating fibrosis biomarkers in statin-naïve patients with hypertension with atherosclerosis. J Investig Med 2016; 64:1194-9. [DOI: 10.1136/jim-2016-000092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2016] [Indexed: 12/16/2022]
Abstract
The purpose of this study was to assess the effects of 12 weeks of atorvastatin treatment on myocardial fibrosis in patients with hypertension with atherosclerosis. 15 statin-naïve participants (11 males; mean age 67±10 years) with atherosclerosis were given atorvastatin (40 mg/day) for 12 weeks and underwent echocardiography including ultrasonic tissue characterization by cyclic variation of integrated backscatter (CVIBS). Serum galectin-3 and fibrosis markers including aminoterminal propeptide of type III procollagen (PIIINP), matrix metalloproteinase-2, metalloproteinase-9, and tissue inhibitor of metalloproteinase-1 (TIMP-1) were also analyzed. After 12 weeks of atorvastatin (40 mg/day) treatment, serum total cholesterol and low-density lipoprotein cholesterol decreased significantly (204±31 to 140±24 mg/dL and 133±26 to 69±17 ng/mL, respectively, both p<0.001). In myocardial fibrosis analysis, CVIBS increased significantly (6.6±1.9 to 8.5±2.7 dB, p=0.024). In addition, the circulating fibrosis markers serum PIIINP and TIMP-1 decreased significantly (9.5±2.7 to 6.4±1.4 ng/mL, p=0.012 and 299±65 to 250±45 ng/mL, p=0.024, respectively). 12 weeks of medium dose atorvastatin treatment resulted in a significant reduction in myocardial fibrosis as evaluated by morphofunctional parameters and plasma markers of tissue fibrosis.Trial registration numberNTC00172419; results.
Collapse
|
14
|
Rosuvastatin: Beyond the cholesterol-lowering effect. Pharmacol Res 2016; 107:1-18. [PMID: 26930419 DOI: 10.1016/j.phrs.2016.02.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/13/2016] [Accepted: 02/14/2016] [Indexed: 12/18/2022]
|
15
|
Heo YA, Son M, Park K. Blood pressure lowering effect of statin drugs with an application to rosuvastatin. Transl Clin Pharmacol 2016. [DOI: 10.12793/tcp.2016.24.3.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Young-A Heo
- Department of Pharmacology, Yonsei University College of Medicine, Seoul 03722, Korea
- Brain Korea 21 Plus Project for Medical Science, Yonsei University, Seoul 03722, Korea
| | - Mijeong Son
- Department of Pharmacology, Yonsei University College of Medicine, Seoul 03722, Korea
- Brain Korea 21 Plus Project for Medical Science, Yonsei University, Seoul 03722, Korea
| | - Kyungsoo Park
- Department of Pharmacology, Yonsei University College of Medicine, Seoul 03722, Korea
| |
Collapse
|
16
|
The effect of statins on sympathetic activity: a meta-analysis. Clin Auton Res 2015; 25:125-31. [PMID: 25739473 PMCID: PMC4408357 DOI: 10.1007/s10286-015-0274-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/29/2014] [Indexed: 01/13/2023]
Abstract
Objective Beyond lipid-lowering properties, statins decrease sympathetic nervous activity. Due to the limited number of studies and included participants, a meta-analysis of randomized, placebo-controlled studies using microneurography (MSNA) was performed to assess sympatholytic effect of statins. Methods We conducted a comprehensive search of online databases (Cochrane, Embase, and EBSCO) for published human studies up to April 2014. Randomized controlled trials (parallel and crossover design) were eligible for inclusion if results of statins versus placebo treatments on sympathetic activity were measured with MSNA. Results Data from five studies with a total number of subjects n = 82 were included into the meta-analysis. MSNA expressed as bursts/min and as bursts/100 heartbeats was lower in the statin group than in the placebo group with a mean difference of −4.37 95 % CI (−7.03; −1.70), p < 0.0013 and −5.85 95 % CI (−7.56; −4.13), p < 0.0001, respectively. No significant publication bias was observed. Meta-regression revealed no significant effect of baseline total cholesterol or dose of statin. No change in blood pressure and heart rate was observed. Conclusions Published data show that regardless of type and dose, statins reduce sympathetic activity measured by microneurography. The role of decreased sympathetic outflow during statin therapy on clinical end points needs to be clarified.
Collapse
|
17
|
Henry TL, De Brouwer BFE, Van Keep MML, Blankestijn PJ, Bots ML, Koffijberg H. Cost-effectiveness of renal denervation therapy for the treatment of resistant hypertension in The Netherlands. J Med Econ 2015; 18:76-87. [PMID: 25367314 DOI: 10.3111/13696998.2014.978453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Safety and efficacy data for catheter-based renal denervation (RDN) in the treatment of resistant hypertension have been used to estimate the cost-effectiveness of this approach. However, there are no Dutch-specific analyses. This study examined the cost-effectiveness of RDN from the perspective of the healthcare payer in The Netherlands. METHODS A previously constructed Markov state-transition model was adapted and updated with costs and utilities relevant to the Dutch setting. The cost-effectiveness of RDN was compared with standard of care (SoC) for patients with resistant hypertension. The efficacy of RDN treatment was modeled as a reduction in the risk of cardiovascular events associated with a lower systolic blood pressure (SBP). RESULTS Treatment with RDN compared to SoC gave an incremental quality-adjusted life year (QALY) gain of 0.89 at an additional cost of €1315 over a patient's lifetime, resulting in a base case incremental cost-effectiveness ratio (ICER) of €1474. Deterministic and probabilistic sensitivity analyses (PSA) showed that treatment with RDN therapy was cost-effective at conventional willingness-to-pay thresholds (€10,000-80,000/QALY). CONCLUSION RDN is a cost-effective intervention for patients with resistant hypertension in The Netherlands.
Collapse
|
18
|
Effects of Atorvastatin on Resting and Peak Exercise Blood Pressure among Normotensive Men and Women. CHOLESTEROL 2014; 2014:720507. [PMID: 25478215 PMCID: PMC4251356 DOI: 10.1155/2014/720507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/28/2014] [Accepted: 10/28/2014] [Indexed: 11/17/2022]
Abstract
Statins are the most widely prescribed and effective medication for reducing low density lipoprotein cholesterol. Statins may also lower resting blood pressure (BP); however, results are inconsistent. We sought to determine if the maximum dose of atorvastatin reduces resting BP and the peak systolic BP (SBP) achieved on a graded exercise stress test (GEST) among a large sample of 419 healthy men (48%) and women (52%). Subjects (419, 44.1 ± 0.8 yr) were double-blinded and randomized to 80 mg·d−1 of atorvastatin (n = 202) or placebo (n = 217) for 6 mo. Among the total sample, there were no differences in resting BP (SBP, P = 0.30; diastolic BP [DBP], P = 0.69; mean arterial pressure (P = 0.76); or peak SBP on a GEST (P = 0.99)) over 6 mo, regardless of drug treatment group. However, among women on atorvastatin, resting SBP/DBP (3.7±1.5 mmHg, P = 0.01/3.2±0.9 mmHg, P = 0.02) and peak SBP on a GEST (6.5±1.5 mmHg, P = 0.04) were lower versus men. Atorvastatin lowered resting BP 3-4 mmHg and peak SBP on a GEST ~7 mmHg more among women than men over 6 mo of treatment. The inconsistent findings regarding the antihypertensive effects of statins may be partially explained by not accounting for sex effects.
Collapse
|
19
|
Gladwell D, Henry T, Cook M, Akehurst R. Cost effectiveness of renal denervation therapy for the treatment of resistant hypertension in the UK. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2014; 12:611-622. [PMID: 25086585 DOI: 10.1007/s40258-014-0116-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Patients with resistant hypertension are at a high risk for developing serious cardiovascular events and renal complications. Catheter-based renal denervation (RDN) is a procedure with the potential to normalize systolic blood pressure (SBP). OBJECTIVE The overall objective of the study was to estimate the cost effectiveness of RDN in the UK for patients with diagnosed resistant hypertension, expressed as a standard cost per quality-adjusted life-year (QALY) ratio. METHODS A patient lifetime, economic, Markov heath-state model was developed, linking expected changes in SBP to reductions in risks for cardiovascular events and renal complications, using the Framingham, PROCAM, and other published risk equations. The model was developed from the perspective of the healthcare payer in the UK using relevant cost data from 2012. Clinical effectiveness for RDN (a mean reduction of 32 mmHg in SBP) was taken from the phase III Symplicity HTN-2 trial, in patients with a mean baseline SBP of 178 mmHg. HTN-2 was the largest, multicenter randomized controlled trial on the effectiveness of RDN therapy at the time of the model development. A systematic review identified UK-specific sources for utility, mortality, and cost parameter values, and included recently published UK guidelines for the clinical management of hypertension. RESULTS RDN therapy resulted in an increase in health benefit over a patient's lifetime compared with anti-hypertensive pharmacological treatment alone (12.77 vs. 12.16 QALYs; discounted). Additional lifetime costs per patient were modeled at £2,961; equivalent to an incremental cost per additional QALY of £4,805. This result was robust to full probabilistic sensitivity and scenario analyses. CONCLUSION RDN is an effective clinical procedure that offers patients a meaningful and cost-effective alternative for achieving SBP control, where traditional combination, anti-hypertensive pharmacologic strategies have been proven to be ineffective.
Collapse
Affiliation(s)
- Daniel Gladwell
- BresMed Health Solutions, North Church House, Queen Street, Sheffield, S1 2DW, England
| | | | | | | |
Collapse
|
20
|
Zhao X, Yin X, Li X, Yan LL, Lam CT, Li S, He F, Xie W, Sang B, Luobu G, Ke L, Wu Y. Using a low-sodium, high-potassium salt substitute to reduce blood pressure among Tibetans with high blood pressure: a patient-blinded randomized controlled trial. PLoS One 2014; 9:e110131. [PMID: 25338053 PMCID: PMC4206289 DOI: 10.1371/journal.pone.0110131] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 09/06/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives To evaluate the effects of a low-sodium and high-potassium salt-substitute on lowering blood pressure (BP) among Tibetans living at high altitude (4300 meters). Method The study was a patient-blinded randomized controlled trial conducted between February and May 2009 in Dangxiong County, Tibetan Autonomous Region, China. A total of 282 Tibetans aged 40 or older with known hypertension (systolic BP≥140 mmHg) were recruited and randomized to intervention (salt-substitute, 65% sodium chloride, 25% potassium chloride and 10% magnesium sulfate) or control (100% sodium chloride) in a 1: 1 allocation ratio with three months’ supply. Primary outcome was defined as the change in BP levels measured from baseline to followed-up with an automated sphygmomanometer. Per protocol (PP) and intention to treat (ITT) analyses were conducted. Results After the three months’ intervention period, the net reduction in SBP/DBP in the intervention group in comparison to the control group was −8.2/−3.4 mmHg (all p<0.05) in PP analysis, after adjusting for baseline BP and other variables. ITT analysis showed the net reduction in SBP/DBP at −7.6/−3.5 mmHg with multiple imputations (all p<0.05). Furthermore, the whole distribution of blood pressure showed an overall decline in SBP/DBP and the proportion of patients with BP under control (SBP/DBP<140 mmHg) was significantly higher in salt-substitute group in comparison to the regular salt group (19.2% vs. 8.8%, p = 0.027). Conclusion Low sodium high potassium salt-substitute is effective in lowering both systolic and diastolic blood pressure and offers a simple, low-cost approach for hypertension control among Tibetans in China. Trial Registration ClinicalTrials.gov NCT01429246
Collapse
Affiliation(s)
- Xingshan Zhao
- Department of Cardiology, Beijing Jishuitan Hospital, 4 medical college of Peking University, Beijing, China
| | - Xuejun Yin
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Xian Li
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Lijing L. Yan
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Christopher T. Lam
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Shenshen Li
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Feng He
- Department of Cardiology, Beijing Jishuitan Hospital, 4 medical college of Peking University, Beijing, China
| | - Wuxiang Xie
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Ba Sang
- Dangxiong People’s Hospital, Tibet, China
| | - Gesang Luobu
- Tibet Autonomous Region People’s Hospital, Tibet, China
| | - Liang Ke
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Yangfeng Wu
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
- * E-mail:
| |
Collapse
|
21
|
Beneficial effect of high dose statins on the vascular wall in patients with repaired aortic coarctation? Int J Cardiol 2014; 176:40-7. [DOI: 10.1016/j.ijcard.2014.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 06/10/2014] [Accepted: 06/20/2014] [Indexed: 11/23/2022]
|
22
|
Patanè S. Ebola: is there a hope from treatment with cardiovascular drugs? Int J Cardiol 2014; 177:524-6. [PMID: 25205490 DOI: 10.1016/j.ijcard.2014.08.114] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 08/17/2014] [Indexed: 12/24/2022]
Affiliation(s)
- Salvatore Patanè
- Cardiologia Ospedale San Vincenzo - Taormina (Me) Azienda Sanitaria Provinciale di Messina, Contrada Sirina, 98039 Taormina (Messina), Italy. patane-@libero.it
| |
Collapse
|
23
|
Gąsecki D, Kwarciany M, Nyka W, Narkiewicz K. Hypertension, brain damage and cognitive decline. Curr Hypertens Rep 2014; 15:547-58. [PMID: 24146223 PMCID: PMC3838597 DOI: 10.1007/s11906-013-0398-4] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Loss of cognitive function is one the most devastating manifestations of ageing and vascular disease. Cognitive decline is rapidly becoming an important cause of disability worldwide and contributes significantly to increased mortality. There is growing evidence that hypertension is the most important modifiable vascular risk factor for development and progression of both cognitive decline and dementia. High blood pressure contributes to cerebral small and large vessel disease resulting in brain damage and dementia. A decline in cerebrovascular reserve capacity and emerging degenerative vascular wall changes underlie complete and incomplete brain infarcts, haemorrhages and white matter hyperintensities. This review discusses the complexity of factors linking hypertension to brain functional and structural changes, and to cognitive decline and dementia. The evidence for possible clinical markers useful for prevention of decreased cognitive ability, as well as recent data on vascular mechanism in the pathogenesis of cognitive decline, and the role of antihypertensive therapies in long-term prevention of late-life cognitive decline will be reviewed.
Collapse
Affiliation(s)
- Dariusz Gąsecki
- Department of Neurology of Adults, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | | |
Collapse
|
24
|
Banach M, Serban C, Aronow WS, Rysz J, Dragan S, Lerma EV, Apetrii M, Covic A. Lipid, blood pressure and kidney update 2013. Int Urol Nephrol 2014; 46:947-61. [PMID: 24573394 PMCID: PMC4012155 DOI: 10.1007/s11255-014-0657-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/28/2014] [Indexed: 12/24/2022]
Abstract
The year 2013 proved to be very exciting as far as landmark trials and new guidelines in the field of lipid disorders, blood pressure and kidney diseases. Among these are the International Atherosclerosis Society Global Recommendations for the Management of Dyslipidemia, European Society of Cardiology (ESC)/European Society of Hypertension Guidelines for the Management of Arterial Hypertension, American Diabetes Association Clinical Practice Recommendations, the Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease (CKD) Patients, the American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, the Joint National Committee Expert Panel (JNC 8) Evidence-Based Guideline for the Management of High Blood Pressure in Adults, the American Society of Hypertension/International Society of Hypertension Clinical Practice Guidelines for the Management of Hypertension in the Community, the American College of Physicians Clinical Practice Guideline on Screening, Monitoring, and Treatment of Stage 1-3 CKD and many important trials presented among others during the ESC Annual Congress in Amsterdam and the American Society of Nephrology Annual Meeting--Kidney Week in Atlanta, GA. The paper is an attempt to summarize the most important events and reports in the mentioned areas in the passing year.
Collapse
Affiliation(s)
- Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland,
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Mihos CG, Pineda AM, Santana O. Cardiovascular effects of statins, beyond lipid-lowering properties. Pharmacol Res 2014; 88:12-9. [PMID: 24631782 DOI: 10.1016/j.phrs.2014.02.009] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 02/25/2014] [Accepted: 02/27/2014] [Indexed: 12/11/2022]
Abstract
The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, better known as 'statins', are amongst the most widely used medications in the world. They have become a pivotal component in the primary and secondary prevention of coronary artery and vascular disease. However, a growing amount of evidence has suggested that statins also possess strong pleiotropic effects irrespective of their lipid-lowering properties, which include enhancement of endothelial function, anti-inflammatory and anti-atherothrombotic properties, and immunomodulation. The following provides a comprehensive and updated review of the clinical evidence regarding the pleiotropic effects of statins in cardiovascular disorders and their potential therapeutic benefits.
Collapse
Affiliation(s)
- Christos G Mihos
- Columbia University, Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, FL, United States
| | - Andres M Pineda
- Columbia University, Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, FL, United States
| | - Orlando Santana
- Columbia University, Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, FL, United States.
| |
Collapse
|
26
|
Obesity indices and inflammatory markers in obese non-diabetic normo- and hypertensive patients: a comparative pilot study. Lipids Health Dis 2014; 13:29. [PMID: 24507240 PMCID: PMC3921991 DOI: 10.1186/1476-511x-13-29] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 02/05/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of this study was to estimate associations between inflammatory markers and obesity indices in normo- and hypertensive subjects. METHODS 65 obese adult subjects were divided into two groups: (A) of hypertensives (n = 54) and (B) of normotensives (n = 11). Waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), visceral adiposity index (VAI), body adiposity index (BAI) and tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and high sensitivity C-reactive protein (hsCRP) serum concentrations were estimated. RESULTS In group A WHtR was higher (0.69 ± 0.07 vs 0.63 ± 0.06; p < 0.01), hsCRP correlated with BMI and WHtR (r = 0.343; p = 0.011 and r = 0.363; p < 0.01, respectively). BAI correlated with hsCRP in group A and B (r = 0.329; p < 0.05 and r = 0.642; p < 0.05; respectively) and in females and males (r = 0.305; p = 0.05 and r = 0.44; p < 0.05, respectively). In females hsCRP was higher (3.2 ± 2.2 mg/l vs 2.1 ± 1.5 mg/l; p < 0.05). In patients without lipid lowering treatment hsCRP and IL-6 were higher (3.2 ± 1.7 mg/l vs 2.4 ±2.2 mg/l; p = 0.01 and 15.9 ± 7.2 pg/ml vs 13.6 ± 9.9 pg/ml; p < 0.01, respectively). CONCLUSIONS WHtR is a sensitive index associated with chronic inflammation in obese hypertensive subjects. BAI correlates with hsCRP independently of hypertension and sex. hsCRP is more sensitive marker associated with obesity than IL-6 and TNF-α. Lipid lowering treatment influence chronic inflammation.
Collapse
|
27
|
Kucera M, Oravec S, Hirnerova E, Huckova N, Celecova Z, Gaspar L, Banach M. Effect of atorvastatin on low-density lipoprotein subpopulations and comparison between indicators of plasma atherogenicity: a pilot study. Angiology 2013; 65:794-9. [PMID: 24163116 DOI: 10.1177/0003319713507476] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Treatment with statins to achieve target low-density lipoprotein cholesterol (LDL-C) levels is still associated with residual risk. Lipoprotein subfraction evaluation can provide additional information regarding atherogenicity in these individuals. Patients (n = 40) with hypercholesterolemia (29 females, mean age 63 years), without previous hypolipemic treatment, were treated with atorvastatin 40 mg/d for 3 months. Atorvastatin significantly reduced total cholesterol (6.7 ± 1.0 vs 4.6 ± 1.3 mmol/L, P < .001), LDL-C (4.3 ± 1.0 vs 2.6 ± 0.9 mmol/L, P < .001), triglycerides (1.8 ± 0.9 vs 1.5 ± 1.00 mmol/L, P < .05), small-dense LDL (sdLDL) fraction 3 to 7 (0.22 ± 0.37 vs 0.09 ± 0.16 mmol/L, P < .001), and apolipoprotein B (apoB; 1.0 ± 0.2 vs 0.74 ± 0.2 g/L, P < .001). There was a negative correlation of atherogenic index of plasma (AIP) with buoyant LDL-1 and LDL-2 (r = -.35; P < .05) and positive with sdLDL-3 to sdLDL-7 (r = .52, P < .001). Administration of atorvastatin 40 mg/d in patients with hypercholesterolemia caused a shift in sdLDL subfractions to large, buoyant subfractions. The AIP better correlated with sdLDL than apoB levels.
Collapse
Affiliation(s)
- Marek Kucera
- 2nd Medical Clinic, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Stanislav Oravec
- 2nd Medical Clinic, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Eva Hirnerova
- 2nd Medical Clinic, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Nada Huckova
- 2nd Medical Clinic, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Zuzana Celecova
- 2nd Medical Clinic, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Ludovit Gaspar
- 2nd Medical Clinic, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
28
|
A meta-analysis of the role of statins on renal outcomes in patients with chronic kidney disease. Is the duration of therapy important? Int J Cardiol 2013; 168:5437-47. [PMID: 24016544 DOI: 10.1016/j.ijcard.2013.08.060] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 08/19/2013] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The efficacy of statin treatment in chronic kidney disease (CKD) patients remains controversial. Therefore, we performed a meta-analysis to investigate whether statins modulate renal function in patients with CKD. METHODS Data from Scopus, PubMed, Web of Science, and the Cochrane Central Register of randomized controlled trials for years 1966-December 2012 were searched for appropriate studies. RESULTS Twenty trials with 6452 CKD subjects randomized to receive either statin or placebo were included. Statin therapy significantly influenced high sensitivity C-reactive protein levels in patients on or off dialysis [-0.28 mg/dl, 95%CI: -0.93 to -0.37; p<0.05 and -0.46 mg/dl, 95%CI: -0.87 to -0.05; p=0.03], respectively], urinary protein (-0.77 g/24 h, 95%CI: -1.24 to -0.29, p<0.02; this effect persisted for treatment ≤12 months), and serum creatinine but only for long-term therapy (3 years) (-0.65 mg/dl, 95%CI: -1.00 to -0.30; p=0.0003). The summary for standardized effect size of mean differences of glomerular filtration rate was 0.29 ml/min/1.73 m(2) (95%CI: 0.01 to 0.58; p=0.04), and depended on treatment duration - a significant increase was observed for between 1 and 3 years of statin therapy (0.50 ml/min/1.73 m(2), 95%CI: 0.40 to 0.60; p<0.0001), with no significant increase for both ≤1 and >3 years of the therapy. CONCLUSION Statins might exert significant renoprotective effects in CKD patients; however, benefit may depend on the duration of treatment. This is an issue that warrants more definitive investigation. More studies are necessary in dialysis patients to credibly evaluate the renal effects of statin therapy.
Collapse
|
29
|
Barylski M, Nikfar S, Mikhailidis DP, Toth PP, Salari P, Ray KK, Pencina MJ, Rizzo M, Rysz J, Abdollahi M, Nicholls SJ, Banach M. Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy—A meta-analysis of 11 randomized controlled trials involving 21,295 participants. Pharmacol Res 2013; 72:35-44. [DOI: 10.1016/j.phrs.2013.03.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 03/20/2013] [Accepted: 03/20/2013] [Indexed: 12/17/2022]
|