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Does Co-administration of Antihypertensive Drugs and Statins Alter Their Efficacy and Safety? A Systematic Review and Meta-analysis of Randomized Controlled Trials

Kanukula, Raju, MPharm*; Esam, Hariprasad, MPharm*; Sundström, Johan, MD, PhD; Rodgers, Anthony, PhD; Salam, Abdul, PhD§

Journal of Cardiovascular Pharmacology: June 2019 - Volume 73 - Issue 6 - p 352–358
doi: 10.1097/FJC.0000000000000671
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Abstract: Antihypertensive drugs (AHTDs) and statins are frequently administered together, but there is uncertainty on whether the presence of one affects the main effects of the other. This systematic review and meta-analysis assessed the effects of co-administered AHTDs and statins on blood pressure (BP) and cholesterol. MEDLINE, Cochrane Central Register of Controlled Trials and drug regulatory agency websites were searched, until January 2018. Twelve double-blind randomized controlled trials that allocated adults with or without hypertension and/or hyperlipidemia (n = 4434) to fixed doses of AHTD alone, statin alone and both drugs together, for ≥4 weeks, were included. BP lowering was similar with AHTD + statin compared with AHTD alone [systolic BP −0.1 mm Hg, 95% confidence interval (CI), −1.0 to 0.8, and diastolic BP −1.0 mm Hg, 95% CI, −2.3 to −0.2]. AHTD + statin compared with statin alone resulted in small reduction in low-density lipoprotein cholesterol (−3.9 mg/dL, 95% CI, −6.1 to −1.7), and this effect was largely associated with co-administration of amlodipine and atorvastatin or rosuvastatin. There was no difference in safety outcomes. Overall, it can be concluded that there is no clinically important difference in the effects of AHTDs and statins whether used separately or together for reduction in BP and low-density lipoprotein cholesterol.

*The George Institute for Global Health, Hyderabad, India;

Department of Medical Sciences, Uppsala University, Uppsala, Sweden;

The George Institute for Global Health, University of New South Wales, New South Wales, Australia; and

§The George Institute for Global Health, University of New South Wales, Hyderabad, India.

Reprints: Abdul Salam, PhD, The George Institute for Global Health, Unit No. 301, Second Floor, ANR Center, Banjara Hills, Hyderabad 500 034, Telangana, India (e-mail: asalam@georgeinstitute.org).

George Health Enterprises, the social enterprise arm of The George Institute for Global Health, has received investment to develop fixed-dose combination products containing aspirin, statin, and blood pressure–lowering drugs.

The authors report no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcvp.org).

Received January 15, 2019

Accepted March 11, 2019

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