Document Detail

Coronary heart disease benefits from blood pressure and lipid-lowering.
MedLine Citation:
PMID:  19232755     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We have reported the benefits of atorvastatin and of an amlodipine-based regimen on coronary heart disease (CHD) events in hypertensive patients in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). We report further analyses on the combined benefits of these interventions. METHODS: 19,342 hypertensive patients were randomised to either an amlodipine or an atenolol-based regimen in the ASCOT Blood Pressure-Lowering Arm (BPLA). 10,305 subjects with total cholesterol <or=6.5 mmol/L were further randomised to atorvastatin 10 mg or placebo in the Lipid-Lowering Arm (LLA). Estimates of CHD risk at baseline based on the Framingham algorithm were compared with observed and predicted event rates throughout ASCOT-LLA. RESULTS: Estimated baseline Framingham risk of CHD events was 22.8 per 1000 patient years. After 3.3 years, when the LLA was stopped, the actual CHD event rate had fallen to 4.8 per 1000 patient years--a reduction of 79% in those assigned amlodipine-based treatment and atorvastatin. CONCLUSIONS: CHD benefits associated with BP and lipid lowering were larger than predicted by previous observational and trial data. We estimate that compared with pre-trial treatment, treating about 55 patients with the amlodipine-based regimen and atorvastatin would prevent one CHD event per year.
Peter S Sever; Neil R Poulter; Stylianos Mastorantonakis; Choon Lan Chang; Bjorn Dahlof; Hans Wedel;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-02-20
Journal Detail:
Title:  International journal of cardiology     Volume:  135     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-15     Completed Date:  2009-09-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  218-22     Citation Subset:  IM    
Clinical Pharmacology and Therapeutics, Imperial College London, International Centre for Circulatory Health, London, UK.
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MeSH Terms
Amlodipine / therapeutic use*
Anticholesteremic Agents / therapeutic use*
Antihypertensive Agents / therapeutic use*
Atenolol / therapeutic use*
Blood Pressure / drug effects
Coronary Disease / drug therapy*,  epidemiology
Heptanoic Acids / therapeutic use*
Hypertension / drug therapy,  epidemiology
Perindopril / therapeutic use
Pyrroles / therapeutic use*
Risk Factors
Risk Reduction Behavior
Sodium Chloride Symporter Inhibitors / therapeutic use
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Antihypertensive Agents; 0/Heptanoic Acids; 0/Pyrroles; 0/Sodium Chloride Symporter Inhibitors; 110862-48-1/atorvastatin; 29122-68-7/Atenolol; 82834-16-0/Perindopril; 88150-42-9/Amlodipine

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