Cardiovascular diseases

Combining statins and antihypertensives boosts stroke prevention

Researchers investigated the efficacy of combined treatment in patients with a risk of cardiovascular diseases

MRI brain scan showing stroke

Source: Science Photo Library

The risk of stroke was reduced by 44% in individuals who took both fixed-dose candesartan 16mg + hydrochlorothiazide 12.5mg and rosuvastatin 10mg, compared with those who took placebo.

High blood pressure and cholesterol both increase the risk of stroke, but it is unknown if combining anti-hypertensive treatment with statins protects against a first stroke.

Researchers carried out a 2x2 factorial design study involving 12,705 people at risk of cardiovascular disease who were randomly assigned to daily antihypertensive treatment (fixed-dose candesartan 16mg + hydrochlorothiazide [HCTZ] 12.5mg) or placebo, and rosuvastatin 10mg or placebo.

Over a median follow-up of 5.6 years, they found that the risk of all stroke was reduced by 30% in those who took rosuvastatin alone, but the risk was not significantly reduced by candesartan/HCTZ alone, compared with placebo. Among those with the highest systolic blood pressure (>143.5 mmHg), candesartan/HCTZ reduced first stroke by 42%.

In those who took both drugs, the risk of first stroke was reduced by 44%, compared with placebo.

The team, who presented their results at the American Heart Association International Stroke Conference in Los Angeles on 25 January 2018, said the findings indicated that patients at moderate risk of cardiovascular disease, with no history of clinical disease, should be considered for the combined treatment[1].

Citation: Clinical Pharmacist DOI: 10.1211/CP.2018.20204400

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