Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease

In a 2-by-2 factorial trial, 12,705 persons at intermediate risk were assigned to candesartan plus hydrochlorothiazide or placebo and to rosuvastatin or placebo. At 5.6 years, combination therapy resulted in a significantly lower risk of cardiovascular events than dual placebo. Cardiovascular diseas...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 374; no. 21; pp. 2032 - 2043
Main Authors: Yusuf, Salim, Lonn, Eva, Pais, Prem, Bosch, Jackie, López-Jaramillo, Patricio, Zhu, Jun, Xavier, Denis, Avezum, Alvaro, Leiter, Lawrence A, Piegas, Leopoldo S, Parkhomenko, Alexander, Keltai, Matyas, Keltai, Katalin, Sliwa, Karen, Chazova, Irina, Peters, Ron J.G, Held, Claes, Yusoff, Khalid, Lewis, Basil S, Jansky, Petr, Khunti, Kamlesh, Toff, William D, Reid, Christopher M, Varigos, John, Accini, Jose L, McKelvie, Robert, Pogue, Janice, Jung, Hyejung, Liu, Lisheng, Diaz, Rafael, Dans, Antonio, Dagenais, Gilles
Format: Journal Article
Language:English
Published: United States Massachusetts Medical Society 26.05.2016
Subjects:
Aged
Antihypertensive Agents - administration & dosage
Antihypertensive Agents - adverse effects
Antihypertensives
Benzimidazoles - administration & dosage
Blood pressure
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
Cerebral infarction
Cholesterol
Cholesterol, LDL - blood
Disease prevention
Double-Blind Method
Drug therapy
Drug Therapy, Combination
Female
Health risk assessment
Heart diseases
Humans
Hydrochlorothiazide
Hydrochlorothiazide - administration & dosage
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage
Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects
Hypertension - drug therapy
Lipids
Low density lipoprotein
Male
Medication Adherence
Middle Aged
Myocardial infarction
Risk Factors
Rosuvastatin Calcium - administration & dosage
Rosuvastatin Calcium - adverse effects
Stroke
Tetrazoles - administration & dosage
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In a 2-by-2 factorial trial, 12,705 persons at intermediate risk were assigned to candesartan plus hydrochlorothiazide or placebo and to rosuvastatin or placebo. At 5.6 years, combination therapy resulted in a significantly lower risk of cardiovascular events than dual placebo. Cardiovascular diseases are major causes of death and illness worldwide. 1 Both systolic blood pressure and low-density lipoprotein (LDL) cholesterol show graded associations with cardiovascular disease and together account for two thirds of the population-attributable risk of cardiovascular disease. 2 – 4 Therefore, combined lowering of LDL cholesterol and blood pressure can potentially have a bigger effect in reducing cardiovascular events than either intervention alone. Because the majority of cardiovascular events occur in persons at average risk with no previous cardiovascular disease, a strategy of broad population-based treatment of LDL cholesterol and blood pressure could be more effective than targeting only high-risk persons. . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1600177