Introduction: Hypertension is found in more than 50% of children with chronic renal failure. Hypertension should be treated to prevent the development of symptomatic cardiovascular disease and to delay progression of chronic renal failure
The hepatic 3-methylglutaryl coenzyme A reductaseinhibitors are molecules of fungal origin. They are competitive inhibitors of HMG-CoA reductase enzyme in cholesterol biosynthesis and prevent the conversion of HMG-CoA to mevalonate (the rate-limiting step in cholesterol biosynthesis). They reduce the risk of cardiovascular disease (heart attacks, strokes, and the need for arterial revascularisation)
Aim of Work: To analyze and define effectiveness of Hepatic 3-methylglutaryl coenzyme A reductase inhibitors (statins) in hypertension.
Methods: Case control studies,meta-analysis, randomized controlled trials and clinical trials were revised of Hepatic 3-methylglutaryl coenzyme A reductase inhibitors (statins( administered to patients with hypertension were identified depend on systematic searches of 4 electronic databases including Cochrane ,science direct andPubMed databases in last 5 years .
Results: Out of 4 databases only 8 studies met the eligibility criteria meta-analysis and case-control studies
Hypertension is a very common disease usually associated with hypercholesterolemia and contributes to increase in cardiovascular diseases.
Strains are the most effective cholesterol-lowering drugs. They were associated with a significant reduce of fatal and non-fatal cardiovascular events in both primary and secondary prevention of cardiovascular disease through reduction in levels of low-density lipoprotein (LDL), reduction triglycerides and small effects on HDL-cholesterol. Although the cardiovascular benefit of statin treatment is cholesterol-lowering action, additional actions called pleiotropic effect, which are independent from strains and might explain cardiovascular protection seen shortly after the initiation of therapy.
Very few studies have demonstrated the antihypertensive effect of statins in patients with hypertension associated with hypercholesterolemia. Other studies aimed for antihypertensive effect of strains provide information about BP during treatment with statins. Present result is hampered by limitations, as small or very small sample size, inadequate study design, too short treatment period, and modification of concomitant antihypertertensive therapy during the trial.
Recently, sub-analyses of some clinical trials suggest that reductions in LDL with statins may be associated with a reduced progression of chronic renal failure.
Conclusion: Hepatic 3-methylglutaryl coenzyme A reductase inhibitors (statins) are recommended for treatment of hypertension secondary to chronic renal failure. The use of statins generally was associated with a significantly lower risk of all cause mortality and morbidity of cardiovascular diseases. The use of statins in hypertension is evidence based. I will recommend the use of strains in this child.
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