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Review
. 2024 Apr 8;16(4):e57825.
doi: 10.7759/cureus.57825. eCollection 2024 Apr.

Statins As Anti-Hypertensive Therapy: A Systematic Review and Meta-Analysis

Affiliations
Review

Statins As Anti-Hypertensive Therapy: A Systematic Review and Meta-Analysis

Zahid Khan et al. Cureus. .

Abstract

Hypertension is the most prevalent condition in clinical practice. Hypertension, diabetes, and hypercholesterolaemia are major contributing factors to cardiovascular diseases. They commonly coexist in a single patient. Statins have been used as prominent medicines for the reduction of cardiovascular events. Statins have been shown to reduce blood pressure in patients with hypertension and have lipid-lowering properties in recent articles. Statins reduce blood pressure because of their impact on endothelial function, their interactions with the renin-angiotensin system, and their influence on major artery compliance. This meta-analysis aimed to ascertain the effectiveness and efficacy of statins for managing hypertension in patients with hypertension. Systematic searches were conducted on PubMed, Science Direct, Embase, Cochrane Library, and Google Scholar. Randomized controlled trials, systematic trials, and cohort studies were retrieved using keywords on statins and their use in patients with hypertension. Exclusion criteria included studies that were not in the English language, studies that did not include patients on statins with hypertension, studies that did not provide enough information, technical reports, opinions, or editorials, and studies involving patients < 18 years old. The inclusion criteria were randomized controlled trials, meta-analyses, adult patients aged > 18 years old, and studies that were freely available or through institutional login. This meta-analysis scrutinized 9361 randomized controlled trials, clinical trials, meta-analyses, and systematic reviews, of which 32 articles including 25 randomized controlled trials and seven meta-analyses were included in the final analysis. This meta-analysis of the role of statins in hypertensive patients aimed to determine the outcome of hypertension control along with antihypertensive medication. Our study showed that statins are useful in reducing both systolic and diastolic blood pressure. We used a heterogeneous model for analysis due to variations in the study characteristics. The I2 value was 0.33 (0.76, 0.10) for systolic blood pressure and 0/88 (0.86, 0.90) for diastolic blood pressure. The I2 value for the seven meta-analyses included in the study was 1.79 (2.88, 0.69).

Keywords: antihypertensive therapy; hypertension and statins; hypertensive individuals on statins; isolated systolic hypertension; randomized controlled trials; rosuvastatin; simvastati; systematic review and meta analysis; systematic reviews of statins; systolic and diastolic blood pressure.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. RoB 2 tool for the randomized controlled trials included in the systematic review
RoB 2: Risk of Bias 2 References: [13,14,20-42]
Figure 2
Figure 2. RoB 2 risk of bias assessment summary plot for the randomized controlled trials included in the meta-analysis
RoB 2: Risk of Bias 2
Figure 3
Figure 3. ROBIS tool for risk of bias assessment in systematic review and meta-analyses
ROBIS: Risk of Bias in Systematic Reviews References: [1,15,19,43,45,46,48]
Figure 4
Figure 4. ROBIS tool for risk of bias assessment in sytematic reviews and meta-analyses included in the study
ROBIS: Risk of Bias in Systematic Reviews
Figure 5
Figure 5. Funnel plot for meta-analyses included in the study
Figure 6
Figure 6. Funnel plot for the randomized controlled trials included in the study
Figure 7
Figure 7. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flow diagram showing searches of databases and registers for current meta-analysis
Figure 8
Figure 8. Systolic blood pressure forest plot for randomized controlled trials included in the meta-analysis
References: [13,14,20-42]
Figure 9
Figure 9. Diastolic blood pressure forest plot for the randomized controlled trials included in the meta-analysis
References: [20-41]
Figure 10
Figure 10. Forest plot for meta-analyses included in this study.
References: [1,15,43,45,46,48]

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