The largest European study of high
blood pressure is published.
Issued on behalf of the Executive Committee of the Anglo-Scandinavian
Cardiac Outcomes Trial (ASCOT)
Medics consider that most strokes and heart
attacks in people with high blood pressure can be avoided by
simply combining effective, modern blood pressure lowering drugs with
treatment
to reduce cholesterol.
The success of this treatment strategy has been
investigated for the first time in the largest study of high blood
pressure treatment ever conducted
in Europe – the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) – which
was presented at the congress of the European Society of Cardiology
and published online in The Lancet.
ASCOT included more than 19,000 men and women with high blood pressure
who were at a moderate risk of strokes and heart attacks. To control
their blood pressure, they received either the newer drugs – a
calcium antagonist, amlodipine and the ACE inhibitor, perindopril – or
a traditional combination of a beta-blocker, atenolol and a diuretic.
Additionally, 10,000 patients were also treated with the cholesterol
lowering drug atorvastatin or a placebo (dummy pill).
This is the only
major European study to-date to combine these two treatment strategies.
Co-Chairman of the ASCOT Steering Committee, Professor Peter Sever,
Professor of Clinical Pharmacology and Therapeutics at the International
Centre
for Circulatory Health, Imperial College, London, said:
“ The
patients treated in ASCOT were those generally seen in everyday practice.
They had high blood pressure plus three additional risk factors – aged
over 55, male gender, smoker. They were seen as being at moderate risk.
The combination of the contemporary blood pressure lowering drugs,
amlodipine and perindopril, plus effective lowering of cholesterol
abolished more than half the risk of strokes and heart attacks – the
most important causes of death in millions of men and women with high
blood pressure.”
The final results of ASCOT, which was conducted in the UK, Ireland and
Scandinavia, showed that the combination of newer blood pressure lowering
drugs reduced the risk of strokes by about 25%, coronaries by 15% and
new cases of diabetes by 30% compared with the standard treatment.
The addition of the cholesterol lowering drug, atorvastatin, still further
reduced the remaining risk irrespective of the patient’s original
cholesterol level. Indeed, the ASCOT patients only had average or below
average levels of cholesterol at the outset of the study.
As a result of the reductions in heart attacks and strokes in patients
receiving the cholesterol lowering drug and those treated with the modern
blood pressure lowering drugs, both parts of ASCOT were terminated early
by the independent Data Safety Monitoring Board.
Commenting on the importance of these results, Co-Chairman of the study,
Professor Björn Dahlöf, Associate Professor in the Department
of Medicine at Sahlgrenska University Hospital/Östra, University
of Gothenburg, Sweden, said:
“ High blood pressure is a major
public health problem. Despite the availability of effective blood
pressure lowering drugs, many people who are being treated still suffer
strokes, heart attacks and other related diseases, such as diabetes.
Now, the evidence from ASCOT offers us a simple and effective combination
of treatments which both control the blood pressure and lower cholesterol
to more effectively reduce this risk. This is very important news for
patients and their physicians.”
Following the study, the investigators believe that international recommendations
for managing high blood pressure may need to be reviewed. Additionally,
they suggest that most patients with hypertension should also be considered
for a cholesterol lowering drug.
However, they emphasise that patients taking beta-blockers and diuretics
should not discontinue their treatment. The Co-Chairmen of the study,
Professors Sever and Dahlöf concluded:
“ This is an effective
and proven combination for lowering blood pressure and its associated
risks. What ASCOT has shown is that for many patients the combination
of newer drugs may be an even better option. Patients should discuss
the implications of ASCOT with their physicians before any modification
of treatment is considered.”
The final results of the Blood Pressure Lowering
Arm (BPLA) of ASCOT will be published in The Lancet online on 4th September
2005 (www.thelancet.com)
and explanations for the benefits seen are reviewed in a separate paper
also published online.
News is included on this website
to inform visitors about current health issues, but not to endorse
any particular view or activity. Material in this news item
was first published by the British Hypertension Society on 4th September
2005. For further information, please visit their
website using the link below. |
