Combining drugs that lower blood pressure and cholesterol could do more to prevent stroke
American Heart Association Meeting Report Presentation 104 - Session: A19
- 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 Association’s 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, it’s 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:
Taking daily doses of two blood pressure drugs (fixed dose candesartan and hydrochlorothiazide) along with a cholesterol-lowering drug (low-dose rosuvastatin), proved to be the most effective, cutting first-time strokes by 44 percent among patients at intermediate risk for heart disease.
For those with very high blood pressure -- readings 143.5 mm Hg or higher -- taking 16 milligrams of candesartan plus 12.5 milligrams of hydrochlorothiazide every day reduced stroke by 42 percent.
Compared with a placebo, stroke was reduced by 30 percent among participants taking daily doses of 10 milligrams of rosuvastatin.
“These results indicate that to prevent stroke in those at moderate risk, blood pressure lowering plus cholesterol-lowering should be considered in those with elevated blood pressure, and cholesterol-lowering should definitely be considered for all,” said lead study author Jackie Bosch, Ph.D., McMaster University in Hamilton, Ontario, Canada. “These are existing drugs that are well-tolerated, have strong safety profiles and it is easy for patients to stick with them.”
The findings come from the Heart Outcomes Prevention Evaluation Study, a large, international study focused on heart disease and stroke prevention. The average age of the participants was 66 years; 46 percent were women, and 166 strokes occurred during an average follow-up of 5.6 years. At the start of the study, the average blood pressure was 138/82 mm Hg. A normal blood pressure reading is around 120/80 mm Hg.
Based on these findings, Bosch said researchers are now looking at developing a single pill that produces the same effects as taking multiple pills that lower both blood pressure and cholesterol.
Co-authors are Evan Lonn, M.D.; Jun Zhu, M.D.; Prem Pais, M.D.; Denis Xavier, M.D.; Antonio Dans, M.D.; Rafael Diaz, M.D.; Robert Hart, M.D.;and Salim Yusuf, M.B. B.S., D.Phil. Author disclosures are on the abstract. The National Institutes of Health funded the study.
Presentation location: Room 515A
- Available downloadable video interviews with ASA expert and the study researcher, B-roll, animation and images related to this news release are on the right column of the release link
- Stroke Prevention
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Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.
About the American Stroke Association
The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit StrokeAssociation.org. Follow us on Facebook and Twitter.
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