Statin drugs are prescribed to reduce your risk of experiencing a heart attack and stroke. While statins mainly work by lowering a raised cholesterol level, new evidence suggests that taking a statin may also lower your blood pressure.
Statins and blood pressure
A large study published in the medical journal, Clinical and Experimental Hypertension, looked at the effect of statins on blood pressure in 5.9 million drug adverse event reports filed in the U.S. for the statins: atorvastatin, simvastatin and rosuvastatin.
The results showed that:
- atorvastatin increased the relative risk of experiencing low blood pressure (hypotension) that was significant enough to warrant an adverse event report by 26%
- simvastatin increased the risk of significant hypotension by 94%
- rosuvastatin did not appear to have any significant effect on blood pressure.
This confirms the results from a previous study which asked ‘Do statins reduce blood pressure?’ This initial analysis looked at the results of 20 trials, involving 828 people who were either on a stable dose of antihypertensive medication, or not taking any blood pressure treatments.
Of these, some were given either a statin or a placebo for a certain amount of time, then switched to receive the other treatment to see if their blood pressure changed.
Overall, while taking the statin, their systolic blood pressure (upper reading) was significantly lower than when taking the placebo, with an average reduction of -1.9 mmHg. The effect was mostly confined to people with a systolic blood pressure that was raised to greater than 130 mmHg, who experienced an average fall in systolic blood pressure of -4.0 mmHg. Reductions in diastolic blood pressure (lower reading) were around -2.7mmHg.
The blood pressure response to taking a statin was not related to age, any changes in cholesterol level or the length of time the statin was taken. This suggested that taking a statin can have a small but clinically meaningful beneficial effect on your blood pressure if it is raised and you are taking antihypertensive medication.
How do statins lower blood pressure?
Statins lower cholesterol levels by blocking the effects of an enzyme, HMG-CoA needed to make cholesterol (mainly in the liver). This effect does not seem to relate to their blood pressure lowering action, however.
Laboratory studies suggest that statins may lower blood pressure by:
- increasing the production of nitric oxide (NO) in blood vessel linings to trigger dilation of arteries
- reducing the release of endothelin-1 which causes blood vessels to constrict
- reducing the production of superoxide free radicals
- improving arterial elasticity through an effect on smooth muscle cells lining larger arteries
- reducing the production of angiotensin-11 receptors.
Should you take a statin drug?
Statins are controversial. If your doctor recommends that you take a statin drug, you can use the Statin Choice Decision Aid from the Mayo Clinic in the US, or the Statin Patient Decision Aid from the National Institute for Health and Care Excellence (NICE) in the UK.
If you do decide to take a statin, it’s important to know that a statin lowers blood levels of coenzyme Q10 and statins lower vitamin D levels. Taking these two vital nutrients as supplements may help to reduce muscle-related statin side effects.
Have you found taking a statin affects your blood pressure?