Heart attack and stroke risk from hypertension is reduced by statins and blood pressure drugs. Research suggests that combining statins for cholesterol with blood pressure medications reduced the risk of heart disease by 40 percent.
The trial, known as HOPE-3, could push doctors to add statins to patient’s blood pressure treatment even if they have no history of heart attack and stroke.
Patients enrolled in the trial had at least one risk factor for heart disease and were over the age of 60 if female and over the age of 55 if male.
Head of the study Dr. Salim Yusuf said, “Intermediate-risk people with hypertension had a clear benefit when taking both a statin and an agent that lowers blood pressure.”
High blood pressure was defined as systolic blood pressure over 140. Patients experienced a 40 percent reduction in the risk of heart attack and stroke over the course of six years while taking AstraZeneca Plc’s Crestor statin as well as a combination tablet containing blood pressure treatment candesartan and the diuretic hydrochlorothiazide.
Patients with low or normal systolic blood pressure who took both medications experienced a 25 percent reduction in cardiovascular events, compared to those who only took blood pressure medication.
The findings suggest that individuals with systolic blood pressure over 140 would benefit from receiving blood pressure medications and statins in order to significantly reduce their risk of heart attack and stroke.
Prehypertension is a condition in which the blood pressure readings fall between 120/80 mmHg and 139/89 mmHg. Lead researcher Dr. Ilke Sipahi explained, “Our study pertains to people with prehypertensive blood pressure levels and shows that the excess risk of stroke associated with these high-normal readings (top number 120-140) can be altered by taking blood pressure pills.”
The study was based on the meta-analysis of 16 studies. Researchers compared antihypertensive drugs against placebos in 70,664 individuals, with average baseline blood pressure within the prehypertensive range. The researchers found that patients who took blood pressure medication had a reduction in their risk of stroke by 22 percent, compared to those taking a placebo. There was also no significant reduction in heart attack risk, but there was a positive trend towards improved cardiovascular health, compared to those on placebos. And, finally, to prevent one stroke in the study population, 169 people had to be treated with a blood pressure-lowering medication for an average 4.3 years.
The American Heart Association recommends that lifestyle changes be a large part in an individual’s life in order to improve heart health instead of solely relying on medications. Lifestyle changes including improving one’s diet, exercising regularly, not smoking, maintaining a healthy weight, minimizing alcohol consumption, reducing salt intake, and consuming plenty of fruits and vegetables.
Sipahi concluded, “We do not think that giving blood pressure medicine instead of implementing the lifestyle changes is the way to go. However, the clear-cut reduction in the risk of stroke with blood pressure pills is important and may be complementary to lifestyle changes. The cost of long-term therapy and the risks associated with blood pressure medicines need to be discussed extensively within the medical community before undertaking guideline changes.”