Issue 176 Item 12 Pravastatin Plus Captopril Reduces Lipid Levels in Hypertensiv

A dual therapy regiment of pravastatin and captopril appears to improve lipid and glucose metabolism while decreasing blood pressure.

That from a study presented at the 13th International Symposium on Atherosclerosis.

Hiroshi Shionoiri and colleagues, Yokohama City University Japan, believe that this long-term combination therapy may reduce the occurrence of cardiovascular episodes in hypertensive patients with dyslipidemia.

A group of 24 patients with a mean age of 58 years, who were both hypertensive and hypercholesterolemic, participated in the 2-year investigation. Patients with secondary hypertension, secondary dyslipidemia, renal insufficiency, and other malignant diseases were excluded from participating in this research. The researchers defined hypercholesterolemia as a total cholesterol level greater than 240 mg/dL.

At the beginning of the study, mean total cholesterol level was 254 mg/dL, mean low-density lipoprotein (LDL) level was 173 mg/dL, and triglyceride level was 190 mg/dL. Impaired glucose tolerance was identified in 11 of the participants.

After a 2 month placebo run-in period, patients were treated with 37.5 to 75 mg/day of captopril for 6 months, and then 10 mg/day of pravastatin was added to the regimen for the next 18 months.

There were no adverse drug interactions, but 2 participants were removed from the study due to the development of cough and rash.

During the initial 6 month captopril treatment, blood pressure was reduced from a mean of 169/101 mm Hg to 146/84 mm Hg. Similar blood pressure results were maintained throughout the combination therapy period as well. In addition, serum lipid levels were significantly decreased by 13.9% in total cholesterol, 19.9% in LDL, and 13.9% in triglycerides. Mean high-density lipoprotein (HDL) level was improved from 42.9 mg/dL to 49.9 mg/dL; mean fasting plasma glucose level decreased from 110 to 99 mg/dL; mean hemoglobin A1C level improved from 6.8% to 6.2%.

The researchers concluded that a combination of captopril and pravastatin may provide lasting cardiovascular protection for hypertensive patients with hypercholesterolemia.

[Study title: Long-Term Combination Therapy With an HMG CoA Reductase Inhibitor, Pravastatin, and an ACE Inhibitor, Captopril, Seems to be Beneficial for Hypercholesterolemic Hypertensives. Abstract 1P-0091]