Patients with high blood pressure and moderate risk of heart disease slashed their long-term risk of heart attack and stroke 40 percent by taking a blood pressure medication as well as a statin cholesterol fighter, according to a large global study that could change medical practice.
Results from the trial, called HOPE-3, could prod far more doctors to add a statin to blood pressure therapy for such patients who have no prior history of heart attack or stroke, researchers said.
The data was presented on Saturday at the annual scientific sessions of the American College of Cardiology in Chicago.
To enroll in the trial, patients had to have at least one risk factor for heart disease such as obesity or smoking, in addition to being over 60 for women and over 55 for men.
"Intermediate-risk people with hypertension had a clear benefit when taking both a statin and an agent that lowers blood pressure," Dr. Salim Yusuf, a professor of cardiology at McMaster University in Ontario, Canada who headed the 12,000-patient global study, said in an interview.
Patients with systolic blood pressure of 140 and higher were deemed in the study to have high blood pressure. They experienced a 40 percent reduced risk of heart attack and stroke over a six-year period when taking AstraZeneca Plc's Crestor statin as well as a combination tablet containing blood pressure treatment candesartan and the diuretic hydrochlorothiazide.
Patients with normal or low systolic pressure had the same approximate 25 percent reduction in cardiovascular events as seen among patients in one arm of the study who took only statins.
Yusuf said the trial underscores that if a patient at moderate heart risk has high blood pressure, defined as 140 or higher, "give them both a statin and a blood pressure medication as a matter of course." He said statins are not automatically given now to patients with hypertension that are at only moderate risk of heart attack or stroke.
Yusuf's trial included research centers in China, India, Latin America, Africa and Canada, but not the United States because of far greater research costs there. The trial was funded by the Canadian Institutes of Health Research and AstraZeneca.
A separate study published in November found that lowering blood pressure to below 120 dramatically reduced heart failure and risk of death in adults aged 50 and older. But the five-year US government-sponsored study of more than 9,300 patients showed a higher rate of adverse side effects, including kidney damage, in the aggressively treated patients.