Statins may directly affect blood pressure regulation, independently of their lipid-lowering properties. A report by scientists from the University of Sassari shows that simvastatin therapy reduces blood pressure and urinary albumin excretion rate (AER) in patients with type 2 diabetes and microalbuminuric hypertension.
Giancarlo Tonolo and colleagues studied 26 microalbuminuric hypertensive type 2 diabetics with baseline diastolic blood pressure of 90–100 mmHg and LDL cholesterol of 3.9–6.5 mmol/L. Subjects were randomly assigned to receive either simvastatin 20 mg a day or cholestyramine 6 g three times a day for 10 months, in a crossover regimen with a three-month washout period. Although both drugs reduced LDL cholesterol levels by a clinically significant amount, only simvastatin treatment was accompanied by reductions in diastolic blood pressure and urinary excretion of albumin and glycosaminoglycan. Neither diastolic blood pressure nor AER correlated with changes in LDL cholesterol, the authors report. Simvastatin therapy was also associated with significant reductions in low sulfate chondroitin-sulfate complex, as well as significant increases in serum total nitrates/nitrites.
Our results clearly show for the first time that the reduction of blood pressure, together with urinary AER — two established CV risk factors — is in large part independent of the reduction in LDL cholesterol," Tonolo and colleagues conclude. They speculate that the results regarding serum nitrates and nitrites "suggest that simvastatin may activate nitric oxide production resulting in a reduction in diastolic blood pressure and possibly AER."