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Coronary heart disease benefits from blood pressure and lipid-lowering

Peter S Sever1, Neil R Poulter, Stylianos Mastorantonakis

  • 1Clinical Pharmacology and Therapeutics, Imperial College London, International Centre for Circulatory Health, London, UK. p.sever@imperial.ac.uk

International Journal of Cardiology
|February 24, 2009
PubMed

Insights

Combining amlodipine-based treatment and atorvastatin significantly reduced coronary heart disease (CHD) events in hypertensive patients. This combined therapy offers substantial cardiovascular protection, preventing one CHD event annually for every 55 patients treated.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Previous studies in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) demonstrated benefits of atorvastatin and amlodipine-based regimens for coronary heart disease (CHD) in hypertensive patients.
  • Further analysis explored the combined effects of these interventions on cardiovascular outcomes.

Purpose of the Study:

  • To evaluate the combined benefits of amlodipine-based treatment and atorvastatin on coronary heart disease (CHD) events in hypertensive patients.
  • To compare observed event rates with predicted CHD risk using the Framingham algorithm.

Main Methods:

  • 19,342 hypertensive patients were randomized to amlodipine or atenolol-based regimens (ASCOT Blood Pressure-Lowering Arm).
  • 10,305 patients with cholesterol <= 6.5 mmol/L were further randomized to atorvastatin 10 mg or placebo (ASCOT Lipid-Lowering Arm).

Main Results:

  • Estimated baseline CHD event risk was 22.8 per 1000 patient-years.
  • After 3.3 years, the observed CHD event rate decreased to 4.8 per 1000 patient-years, a 79% reduction in the amlodipine-atorvastatin group.

Conclusions:

  • The combination of blood pressure and lipid lowering demonstrated greater CHD benefits than predicted.
  • Treating approximately 55 patients with the amlodipine-based regimen and atorvastatin could prevent one CHD event annually compared to pre-trial treatment.
Abstract

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