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 >or=239 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 (>or=140 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 antihypertensive 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.