The Benefits Of Commonly Used Blood Pressure And Cholesterol Lowering Treatment Can Last 16 Years
Fewer deaths from stroke had occurred in people who had high blood pressure treated with amlodipine, a calcium-channel blocker, compared to atenolol, 10 years after the end of a large trial. People with high blood pressure who took statins were less likely to die from cardiovascular diseases, such as heart disease or stroke than those taking a placebo.
This study followed over 7,000 UK patients who had taken part in a clinical trial of blood pressure and cholesterol-lowering treatments between 1998 and 2005. It compared those who had been allocated to amlodipine with those who took atenolol. Those in either blood pressure group who had not already received a statin were also randomised to either atorvastatin or placebo.
Some caution is needed in interpreting these findings because no details were available on what treatments were taken after the trial ended. Both arms of the original trial were stopped early because of the superiority of amlodipine-based treatment over atenolol-based treatment and atorvastatin over placebo. But it is likely that all groups received similar post-trial management according to best practice at the time. The results add important information for clinicians and patients considering the long-term implications of taking these medications.
Combining Drugs That Lower Blood Pressure And Cholesterol Could Do More To Prevent Stroke
Study Highlights:
- Combining medication that lowers blood pressure with medication that lowers cholesterol reduced first-time strokes by 44 percent.
- For those with very high blood pressure readings 143.5 mm Hg or higher taking two types of blood pressure-lowering drugs together every day reduced stroke by 42 percent.
Embargoed until 8 a.m. Pacific Time/11 a.m. Eastern Time, Thursday Jan. 25, 2018
This news release is featured in an embargoed media briefing at 3 p.m. PT Wed., Jan. 24, 2018
LOS ANGELES, Jan. 25, 2018 Combining medication that lowers blood pressure with medication that lowers cholesterol reduced first-time strokes by 44 percent, according to research presented at the American Stroke Associations International Stroke Conference 2018, a world premier meeting dedicated to the science and treatment of cerebrovascular disease for researchers and clinicians.
Seventy-five percent of strokes are first-time strokes. High blood pressure and high cholesterol both increase the risk for stroke, the fifth leading cause of death in America. Yet, its not known whether combining drugs that lower blood pressure and cholesterol levels can protect individuals from stroke.
Now, a study involving 12,705 participants from 21 countries shows that individually, drugs that lower blood pressure or cholesterol do indeed reduce stroke risk, but when combined, they offer even greater protection.
Among the findings:
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Statins May Lower Blood Pressure Slightly
Statin use also appears to decrease blood pressure, although just modestly, which is not significant enough to rival existing blood pressure medications.
A British study in 2007 reported that among statin users, readings were reduced by an average of 1.9 mmHg for systolic blood pressure and 0.9 mmHg for diastolic blood pressure. These units of measurement for blood pressures are represented by the “first” or “top number” indicating the systolic reading and the “second” or “bottom” number indicating the diastolic reading. In patients whose blood pressure started very high, statins appeared to produce a 4.0 mmHg drop in systolic pressure.
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Statins And High Blood Pressure
Your doctor may prescribe medication to help control your blood pressure. Statins are a type of medication usually used to lower cholesterol.
Statins are designed to bring down your low-density lipoprotein , or bad cholesterol. They do this by lowering the amount of cholesterol plaque that forms in the arteries.
Cholesterol plaque narrows your bloods pathways. This reduces the amount of blood that reaches your organs and muscles. When an artery eventually becomes blocked, serious health problems can result.
If a coronary artery is blocked, a heart attack results. If blood flow to the brain is blocked, a stroke occurs.
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Do Statins Affect Blood Pressure
Q. I have been arguing with a friend about whether the statin drugs lower blood pressure. Do they, or don’t they?
A. Statins may lower blood pressure the evidence is still thin but if they do, the effect is small. Few of the multitude of trials testing these cholesterol-lowering medicines checked blood pressure before and after and kept the use of blood pressure medicines constant. An analysis of the results of the few small trials that took these steps showed a reduction of almost 2 points in systolic blood pressure and a reduction of under 1 point for the diastolic pressure . Note that these are average changes, and the effect in individuals can be bigger or smaller.
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Statins Lower Heart Attack Stroke Risk In People At Average Risk
Editors note: This is one in a 10-part series of the top medical research advances of 2016 as determined by the American Heart Association.
Millions more people worldwide may benefit from cholesterol-lowering statins after a global study showed the drugs help reduce heart attacks and strokes in people at moderate risk. The risk fell slightly further when patients also took blood pressure drugs.
Medications to lower blood pressure have been shown to reduce the risk of heart disease in people with elevated blood pressure and those at high risk, and statins have been shown to benefit those at high risk. But a group of researchers wanted to know if treating each condition alone or simultaneously might prevent heart attacks and strokes in an ethnically diverse group of average-risk people without cardiovascular disease.
The study, called Heart Outcomes Prevention Evaluation-3, or HOPE-3, found that the dual low-dose therapy is the best way to reduce cardiovascular risk in older people with elevated blood pressure and nearly normal cholesterol but who had another risk factor such as smoking or obesity. The results were published last April in The New England Journal of Medicine in three papers, and the research was selected as one of the American Heart Associations top 10 heart and stroke science advances of 2016.
HOPE-3s findings reinforce 2013 guidelines from the AHA and American College of Cardiology that recommend statins for more people.
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Other Benefits Of Statins
According to the Journal of Cardiovascular Pharmacology and Therapeutics, statins may do more for your arteries than just lower cholesterol. It suggests that statins can help reduce the risk of narrowed arteries. They do this by keeping the muscle lining of the arteries healthy.
They can also reduce the deposits of fibrin in the arteries. Fibrin is a type of protein involved in blood clot formation.
According to the Archives of Internal Medicine , even with modest improvement in blood pressure from statin use, the risk of heart attack and stroke will still diminish. Anything that helps reduce your risk even a little is welcome, especially if youre at high risk for a cardiovascular event.
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Focus On Your Overall Risk
Though blood pressure and cholesterol levels are important, other factors play a role, tooincluding your age, gender, race, and whether you smoke or have diabetes.
Everyone 40 and over should know their overall risk of having a heart attack or stroke, says Marvin M. Lipman, M.D., Consumer Reports chief medical adviser.
So he and other experts recommend estimating your 10-year risk by using a calculator developed by the American College of Cardiology and the American Heart Association, at tools.acc.org/ASCVD-Risk-Estimator. The ideal is a 10-year risk thats less than 7.5 percent.
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Cholesterol Levels In Dialysis Patients
In a study of dialysis patients, those with higher cholesterol levels had lower mortality than those with low cholesterol.51 Yet the authors claimed that the inverse association of total cholesterol level with mortality in dialysis patients is likely due to the cholesterol-lowering effect of systemic inflammation and malnutrition, not to a protective effect of high cholesterol concentrations. Keeping an eye on further funding opportunities, the authors concluded: These findings support treatment of hypercholesterolemia in this population.
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