Resistant arterial hypertension and hyperlipidemia: Atorvastatin, not vitamin C, for blood pressure control

Eli Magen, Reuven Viskoper, Joseph Mishal, Rita Priluk, Arkadi Berezovsky, Anni Laszt, Daniel London, Chaim Yosefy

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Background: Hypertension is considered resistant if blood pressure cannot be reduced to < 140/90 mmHg with an appropriate triple-drug regimen, including an oral diuretic, with all agents administered at maximal dosages. This definition has evolved with the development of new therapies and evidence-based data supporting treatment to lower BP goals. Objective: To assess whether vitamin C and atorvastatin improve endothelial function and blood pressure control in subjects with resistant arterial hypertension and dyslipidemia. Methods: Forty-eight hyperlipidemic subjects with RH (office systolic BP > 140 mmHg and/or office diastolic BP > 90 mmHg notwithstanding antihypertensive treatment with three medications in maximal doses) were randomized into three groups to receive additional medication for 8 weeks. Group VTC (n = 17) - mean 24 hour SBP 150.6 ± 5.2 mmHg, DBP 86.1 ± 3.3 mmHg, low density lipoprotein 158.1 ± 24.5 mg/dl - received vitamin C 500 mg per day; Group ATR (n = 15) - mean 24 hour SBP 153.1 ± 4.8 mmHg, DBP 87.1 ± 6.7 mmHg, LDL 162.6 ± 13.6 mg/dl - received atorvastatin 20 mg/day; and Group PLA (n = 16) - mean 24 hour SBP 151.1 ± 7.4 mmHg, DBP 84.8 ± 5.9 mmHg, LDL 156.7 ± 26.1 mg/dl - received a placebo. High resolution ultrasound was used to calculate brachial artery flow-mediated dilation, and 24 hour ambulatory BP monitoring was performed at study entry and after 8 weeks. Results: In the ATR group there were significant reductions of SBP (ΔSBP1-2: 13.7 ± 5.6 mmHg, P 0.001), DBP (ΔDBP1-2: 7.8 ± 5.7 mmHg, P 0.01), LDL (ΔLDL1-2: 67.7 ± 28.3 mg/dl, P < 0.001) and improvement of brachial artery FMD (ΔFMD2-1: 4.2 ± 2.6%). No significant changes in BP, LDL and FMD were observed in the other two groups. Conclusions: In subjects with RH and dyslipidemia, atorvastatin 20 mg/day compared to vitamin C 500 mg/day may help to achieve better BD control and improve endothelial function in a finite period. A larger trial is needed to assess the drug's efficacy in this population for longer periods.

Original languageEnglish
Pages (from-to)742-746
Number of pages5
JournalIsrael Medical Association Journal
Issue number12
StatePublished - 1 Dec 2004


  • Endothelial function
  • Resistant hypertension
  • Statins
  • Vitamin C

ASJC Scopus subject areas

  • Medicine (all)


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