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  • Yusuf, SalimMcMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Med, Hamilton, ON, Canada. (author)

Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease

  • Article/chapterEnglish2016

Publisher, publication year, extent ...

  • 2016
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-298083
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-298083URI
  • https://doi.org/10.1056/NEJMoa1600177DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • BACKGROUND Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase the risk of cardiovascular disease. Lowering both should reduce the risk of cardiovascular events substantially.METHODS In a trial with 2-by-2 factorial design, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to rosuvastatin (10 mg per day) or placebo and to candesartan (16 mg per day) plus hydrochlorothiazide (12.5 mg per day) or placebo. In the analyses reported here, we compared the 3180 participants assigned to combined therapy (with rosuvastatin and the two antihypertensive agents) with the 3168 participants assigned to dual placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The median follow-up was 5.6 years.RESULTS The decrease in the LDL cholesterol level was 33.7 mg per deciliter (0.87 mmol per liter) greater in the combined-therapy group than in the dual-placebo group, and the decrease in systolic blood pressure was 6.2 mm Hg greater with combined therapy than with dual placebo. The first coprimary outcome occurred in 113 participants (3.6%) in the combined-therapy group and in 157 (5.0%) in the dual-placebo group (hazard ratio, 0.71; 95% confidence interval [CI], 0.56 to 0.90; P=0.005). The second coprimary outcome occurred in 136 participants (4.3%) and 187 participants (5.9%), respectively (hazard ratio, 0.72; 95% CI, 0.57 to 0.89; P=0.003). Muscle weakness and dizziness were more common in the combined-therapy group than in the dual-placebo group, but the overall rate of discontinuation of the trial regimen was similar in the two groups.CONCLUSIONS The combination of rosuvastatin (10 mg per day), candesartan (16 mg per day), and hydrochlorothiazide (12.5 mg per day) was associated with a significantly lower rate of cardiovascular events than dual placebo among persons at intermediate risk who did not have cardiovascular disease. (ClinicalTrials.gov number, NCT00468923.)

Added entries (persons, corporate bodies, meetings, titles ...)

  • Lonn, EvaMcMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Med, Hamilton, ON, Canada. (author)
  • Pais, PremSt Johns Res Inst, Bangalore, Karnataka, India. (author)
  • Bosch, JackieMcMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Sch Rehabil Sci, Hamilton, ON, Canada. (author)
  • Lopez-Jaramillo, PatricioUniv Santander, Fdn Oftalmol Santander, Bucaramanga, Colombia.;Univ Santander, Inst Masira, Sch Med, Bucaramanga, Colombia. (author)
  • Zhu, JunChinese Acad Med Sci, Fu Wai Hosp, Beijing 100730, Peoples R China.;Peking Union Med Coll, Beijing 100021, Peoples R China. (author)
  • Xavier, DenisSt Johns Res Inst, Bangalore, Karnataka, India.;St Johns Med Coll, Bangalore, Karnataka, India. (author)
  • Avezum, AlvaroDante Pazzanese Inst Cardiol, Sao Paulo, Brazil. (author)
  • Leiter, Lawrence A.Univ Toronto, St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada.;Univ Toronto, St Michaels Hosp, Keenan Res Ctr Biomed Sci, Toronto, ON, Canada. (author)
  • Piegas, Leopoldo S.HCor Heart Hosp, Sao Paulo, Brazil. (author)
  • Parkhomenko, AlexanderInst Cardiol, Kiev, Ukraine. (author)
  • Keltai, MatyasSemmelweis Univ, Hungarian Inst Cardiol, H-1085 Budapest, Hungary. (author)
  • Keltai, KatalinSemmelweis Univ, Hungarian Inst Cardiol, H-1085 Budapest, Hungary. (author)
  • Sliwa, KarenUniv Cape Town, Hatter Inst Cardiovasc Res Africa, Dept Med, Soweto Cardiovasc Res Grp, ZA-7925 Cape Town, South Africa. (author)
  • Chazova, IrinaInst Clin Cardiol, Russian Cardiol Res Complex, Moscow, Russia. (author)
  • Peters, Ron J. G.Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands. (author)
  • Held, ClaesUppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)clahe947 (author)
  • Yusoff, KhalidUniv Teknologi Majlis Amansh Rakyat, Selayang, Malaysia.;Univ Coll Sedaya Int Univ, Kuala Lumpur, Malaysia. (author)
  • Lewis, Basil S.Technion Israel Inst Technol, Ruth & Bruce Rappaport Sch Med, Lady Davis Carmel Med Ctr, Haifa, Israel. (author)
  • Jansky, PetrUniv Hosp Motol, Prague, Czech Republic. (author)
  • Khunti, KamleshUniv Leicester, Diabet Res Ctr, Leicester, Leics, England. (author)
  • Toff, William D.Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England.;Glenfield Hosp, Natl Inst Hlth Res, Leicester Cardiovasc Biomed Res Unit, Leicester, Leics, England. (author)
  • Reid, Christopher M.Monash Ctr Cardiovasc Res & Educ Therapeut, Primary Care Diabet & Vasc Med, Melbourne, Vic, Australia.;Curtin Univ, Sch Publ Hlth, Perth, WA 6845, Australia. (author)
  • Varigos, JohnMonash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia. (author)
  • Accini, Jose L.Univ Norte, Barranquilla, Colombia. (author)
  • McKelvie, RobertMcMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Med, Hamilton, ON, Canada. (author)
  • Pogue, JaniceMcMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada. (author)
  • Jung, HyejungMcMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada. (author)
  • Liu, LishengChinese Acad Med Sci, Fu Wai Hosp, Beijing 100730, Peoples R China.;Peking Union Med Coll, Beijing 100021, Peoples R China. (author)
  • Diaz, RafaelInst Cardiovasc Rosario, Rosario, Santa Fe, Argentina. (author)
  • Dans, AntonioUniv Philippines, Coll Med, Manila, Philippines. (author)
  • Dagenais, GillesUniv Laval, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada. (author)
  • McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Med, Hamilton, ON, Canada.St Johns Res Inst, Bangalore, Karnataka, India. (creator_code:org_t)

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  • In:New England Journal of Medicine374:21, s. 2032-20430028-47931533-4406

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