Do Statins Lower Blood Pressure? What a Cardiologist Says About This Surprising Side Effect
Most people won’t see a major change, but it's still worth paying attention to
Key Takeaways
- Statins may slightly lower blood pressure, but the effect is usually modest.
- Sudden or symptomatic low blood pressure after starting statins is uncommon.
- Low blood pressure with symptoms such as dizziness should be discussed with your doctor.
You and your doctor have decided statins are the best option to lower your cholesterol. While you’re excited about finally getting your cholesterol in check, you still have a lot of questions, particularly about how statins may affect other aspects of your health. One question that comes up for many people is whether statins can also lower blood pressure while helping improve cholesterol levels.
If you’re one of the millions of Americans living with high blood pressure, this potential side effect of statins may come as a happy surprise. If you have normal or even low blood pressure already, you may worry about statins lowering your blood pressure too much. We asked a top cardiologist to break down everything you need to know.
What’s considered low blood pressure?
“Low blood pressure, known medically as hypotension, is generally considered a reading below 90/60 mmHg,” explains Dr. Tobb. “It means the force of blood against artery walls is weaker than usual, which can sometimes reduce blood flow to the brain and other organs.” In contrast, high blood pressure is generally defined as a reading of 130/80 mmHg or higher and reflects too much force against the artery walls.
That’s a problem, since elevated readings can increase the risk of heart disease, heart attack and stroke.
How statins work
Statins work primarily in the liver by blocking an enzyme the liver needs to produce cholesterol, explains Kardie Tobb, DO, MS, FASPC, FACC, a board-certified preventive cardiologist and the medical director for the Cone Health HeartCare Women’s Heart Health and Cardio-Obstetrics Clinic. When the amount of cholesterol the body can produce is reduced, so is the amount of LDL, or “bad,” cholesterol circulating in the bloodstream, she adds.
Statins are often prescribed to lower the risk of heart attack and stroke in people who have:
- High cholesterol
- Existing heart disease
- Diabetes
- A family history of early heart disease
Do statins lower blood pressure?
We’ve covered statins and low blood pressure, and now it’s time to address the question you’ve been wondering: Do statins lower blood pressure? Although statins are designed to lower cholesterol specifically and are not prescribed to lower blood pressure, some research has found that they may lead to a small drop in blood pressure in certain people, especially over time, says Dr. Tobb.
So why could statins lower blood pressure even if they’re not intended to do so? “Proposed explanations include improved function of the endothelium (the thin layer of cells lining the inside of blood vessels), reduced inflammation in the blood vessel wall and improved arterial flexibility as cholesterol plaque is stabilized or reduced,” adds Dr. Tobb. “This effect, when it occurs, tends to be small and gradual, not sudden or dramatic.”
What to about statins and lower blood pressure
If you live with high blood pressure, having lower blood pressure likely sounds like a good thing for your health–and it is, generally speaking. But it’s important to keep an eye on your blood pressure to avoid going too low.
“Many healthy, physically fit people naturally run on the lower side without any problems; however, ‘lower is safer’ is not a universal rule,” says Dr. Tobb. “High blood pressure causes damage gradually over years, while very low blood pressure can cause immediate symptoms such as dizziness or fainting if it drops enough to limit blood flow to the brain.” She says other symptoms of low blood pressure include:
- Blurred vision
- Confusion
- Nausea
- Unusual tiredness
- Cold/clammy skin
- Shallow breathing
- A weak pulse
Getting a single low blood pressure reading without any symptoms is generally not dangerous, but low blood pressure readings paired with symptoms warrant a discussion with your doctor, as severe low blood pressure can reduce blood flow to vital organs such as the brain, heart and kidneys, which is a medical emergency, says Dr. Tobb.
“The safest blood pressure is one that is low enough to protect the heart and blood vessels, but high enough to keep organs well supplied with blood and to avoid symptoms,” she adds.
Should you worry about statins lowering your blood pressure too much?
“For the vast majority of people, the blood pressure changes associated with statins are small and do not push blood pressure into an unsafe range,” explains Dr. Tobb. “A significant, sudden or symptomatic drop in blood pressure after starting a statin is uncommon and is more likely explained by another cause such as a change in another medication, dehydration, illness or a coincidental drop unrelated to the statin.”
Still, because everyone responds differently to medications, Dr. Tobb says it’s reasonable to monitor your blood pressure after starting any new medication, including prescribed statins.
What to do if your blood pressure drops while on statins
Given that significant drops in blood pressure while taking a statin are uncommon, if you do notice lower blood pressure, here’s what Dr. Tobb’s recommends:
Do not panic or stop your statin
While a single low blood pressure reading that happens occasionally doesn’t automatically point to a medical problem, repeated low readings, especially if they’re accompanied by symptoms, should be discussed with your doctor. “Do not stop the statin on your own,” she says. “Cholesterol-lowering benefits build over time, and stopping suddenly without medical guidance can carry its own risks.”
Double check your reading
Even if you’re a pro at reading your blood pressure, there could still be a chance your low reading was off. “Sit quietly for five minutes, keep your feet flat on the floor and your arm supported at heart level, then measure again,” recommends Dr. Tobb. “Take two or three readings a few minutes apart and record the results.” A home blood pressure monitor, such as the Braun ExactFit 3 Upper Arm Blood Pressure Monitor, is an easy way to keep tabs on your readings over time.
Consider other explanations
If you receive a low blood pressure reading or experience symptoms like lightheadedness, nausea or dizziness, consider whether dehydration, a recent illness, skipped meals or another medication could be contributing. Dr. Tobb also recommends keeping a log of your blood pressure readings, symptoms and the date and time they occur so you can review any patterns with your healthcare provider. If the low reading repeats and/or is accompanied by symptoms, talk to your doctor.
The bottom line on statins and low blood pressure
No medication is completely free of side effects, including statins. But what matters most is whether it’s improving your health. If you notice any new or concerning symptoms while taking a statin, including changes in your blood pressure, don’t worry. Take it as an opportunity to continue to support your health by keeping track of your symptoms and discussing them with your doctor.
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