Association between different lipid-lowering treatment strategies and blood pressure control in the Brisighella Heart Study

Background Small studies have suggested that lipid-lowering strategies, and particularly statins, could influence blood pressure (BP) control. The aim of the present study was to evaluate the effect of different lipid-lowering strategies on BP control of subjects with hypercholesterolemia who were enrolled in the prospective, population-based, longitudinal Brisighella Heart Study. Methods A total of 1356 subjects with total cholesterol levels greater than or equal to239 mg/dL were randomly treated for 5 years (1988-1993) with 1 of these lipid-lowering regimens: low-fat diet, cholestyramine, gemfibrozil, or simvastatin. Participants were divided at baseline into 4 quartiles according to systolic BP level and examined for the percent change in systolic and diastolic BP during the 5 years of treatment. Results A significant decrease in BP was observed in the 2 upper quartiles of systolic BP (greater than or equal to140 mm Hg) and was greater in subjects treated with cholesterol-lowering drugs who also had a greater reduction in plasma levels of low-density lipoprotein cholesterol. The BP decrease was greater in patients treated with statin drugs and, among those treated with anti hypertensive drugs, in subjects in the fourth quartile. Conclusion The use of lipid-lowering measures could significantly improve BP control in subjects with both hypercholesterolemia and hypertension. The reduction in BP seems to be enhanced in subjects treated with statins.