Add-on and withdrawal effect of pravastatin on proteinuria in hypertensive patients treated with AT1 receptor blockers

Add-on and withdrawal effect of pravastatin on proteinuria in hypertensive patients treated with AT 1 receptor blockers. Background Although angiotensin receptor antagonists and 3-hydroxy-3-methylgultaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) have been shown to attenuate proteinuria individually, it remains unclear whether proteinuria may be additionally improved by statin therapy in well-controlled hypertensive patients treated with angiotensin receptor antagonists-based regimen and whether withdrawal of chronic statin treatment may abrogate this beneficial effect in normolipidemic patients. Methods A total of consecutive 82 proteinuric patients treated with antihypertensive agents, including losartan, were randomized 10mg of pravastatin or placebo with a 6-month treatment. After completing 6 months of drug treatment, the pravastatin-treated patients were randomly assigned to continue ( N = 19) or withdraw ( N = 17) pravastatin for a further 6 months. Results Subjects treated with pravastatin had significant further improvement of proteinuria at 6 months compared with placebo group (559 ± 251mg/24 hours vs. 1262 ± 557mg/24 hours) ( P r = 0.83, P Conclusion We conclude that pravastatin administration is associated with improved proteinuria probably by inhibiting urine ET-1 levels in patients with losartan-based treatment. However, statin withdrawal abrogates this beneficial effect in patients initially responsive to this therapy.