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Mrc/bhf Heart Protection Study Of Cholesterol-lowering Therapy And Of Antioxidant Vitamin Supplementation In A Wide Range Of Patients At Increased Risk Of Coronary Heart Disease Death: Early Safety And Efficacy Experience

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MRC/BHF Heart Protection Study of cholesterol-lowering therapy and of antioxidant vitamin supplementation in a wide

    European Heart Journal
    |May 18, 1999

    View abstract on PubMed

    Summary
    This summary is machine-generated.

    This study investigated cholesterol-lowering therapy and antioxidant vitamins in high-risk patients. Results showed simvastatin significantly reduced cholesterol, but vitamin supplements had no significant impact on mortality or major events.

    Related Experiment Videos

    Area of Science:

    • Cardiovascular Medicine
    • Clinical Trials
    • Nutritional Science

    Background:

    • Observational studies link lower cholesterol and antioxidant vitamins to reduced coronary heart disease (CHD) risk.
    • High-risk individuals may benefit from cholesterol-lowering therapy regardless of baseline levels.
    • Antioxidant vitamin supplementation is also suggested to lower CHD risk.

    Purpose of the Study:

    • To reliably assess the effects of cholesterol-lowering therapy (simvastatin) and antioxidant vitamin supplementation on mortality and major morbidity.
    • To evaluate these interventions in a diverse population of high-risk patients.
    • To provide evidence on the benefit-risk balance of these treatments in uncertain cases.

    Main Methods:

    • A randomized, 2x2 factorial trial involving 15,454 men and 5,082 women aged 40-80 years at high risk of CHD.
    • Participants received simvastatin (40 mg) or placebo, and antioxidant vitamins (vitamins E, C, beta-carotene) or placebo.
    • Follow-up for at least 5 years with assessments of mortality and major morbidity.

    Main Results:

    • Simvastatin significantly reduced total and LDL cholesterol levels by approximately 1.5-1.6 mmol/L and 1.1-1.2 mmol/L, respectively.
    • Antioxidant vitamin supplementation increased plasma vitamin E levels but showed no significant difference in muscle symptoms or elevated enzymes.
    • Initial follow-up indicated annual rates of 2.4% for non-fatal MI/fatal CHD, 1.3% for stroke, and 2.2% for all-cause mortality.

    Conclusions:

    • The Heart Protection Study is a large trial with well-tolerated regimens producing substantial lipid and vitamin level changes.
    • The study is expected to provide reliable evidence on the efficacy of cholesterol-lowering therapy and antioxidant vitamins.
    • Further analysis will clarify the effects on mortality and morbidity across various high-risk patient categories.