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New Benefits From Old Heart Measures
Date:4/14/2008

Statins lower blood pressure, DASH diet cuts cardiovascular risk, studies find

MONDAY, April 14 (HealthDay News) -- Two new studies describe additional benefits of widely used measures aimed at preventing cardiovascular disease: Cholesterol-lowering statins also reduce blood pressure, and the DASH diet for blood pressure control lowers the incidence of heart disease and stroke in middle-aged women.

The statin study wasn't intended to measure the effect of the drugs on blood pressure, said Dr. Beatrice Golomb, an associate professor of medicine at the University of California, San Diego. It was a classic double-blind, controlled trial with some of the 973 participants taking either simvastatin (Zocor) or pravastatin (Pravachol), and others taking a placebo. Neither doctors nor the participants knew who was taking what.

"But we got enough titillating information that we asked for permission to break the blind, and we looked at blood pressure before any other endpoint," Golomb said.

The blood pressure benefit was there, with systolic pressure (the top number) lower by an average of 2.2 milligrams of mercury for those taking a statin, and diastolic pressure (the bottom number) 2.4 milligrams lower. The reductions were about the same for both statins.

It's not a big drop, Golomb said, but "there are lots of studies showing that on a population basis, a few millimeters of reduction has a big effect on cardiac endpoints."

Golomb said she wouldn't put anyone on a statin expressly for blood pressure reduction, but "some people might be spared the need for a blood pressure medication when they are put on a statin for cholesterol reduction," she said.

The results, published in the April 14 issue of Archives of Internal Medicine, help to explain why treatment with statins has been associated with a reduction in the risk of stroke that couldn't be attributed to the drugs' effect on blood cholesterol, she said.

The DASH -- Dietary Approaches to Stop Hypertension -- study, reported in the same issue of Archives of Internal Medicine, is the first to look at the diet's effect on the incidence of heart disease and stroke, said study author Teresa T. Fung, an associate professor of nutrition at the Simmons College School for Health Studies in Boston.

"Previously, the benefits that were reported were for hypertension [high blood pressure]," Fung said. "No previous study looked at cardiovascular endpoints such as heart disease and stroke."

The study reported on 88,517 female nurses aged 34 to 59 who started with no evidence of cardiovascular disease or diabetes in 1980. In the 24 years that followed, the one-fifth of women in the group whose diets were most similar to that recommended in DASH -- low in animal protein, moderate in low-fat dairy products and high in plant proteins -- were 24 percent less likely to develop coronary heart disease and 18 percent less likely to have a stroke than the one-fifth of women with the lowest DASH scores.

While the study was not the kind of carefully controlled trial that gets the highest regard in research, it carries a message, Fung said. "This report actually shows that those people whose diet resembles the DASH diet reduce the risk of actual cardiovascular disease," she said.

More information

You can learn more about statins from the American Heart Association, and the DASH diet from the U.S. Heart, Lung, and Blood Institute.



SOURCES: Beatrice Golomb, M.D., Ph.D, associate professor, medicine, University of California, San Diego; Teresa T. Fung, Ph.D, associate professor, nutrition, Simmons College, Boston; April 14, 2008, Archives of Internal Medicine


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