Benefits May Persist After Antihypertensive and Statin Treatment


Patients with hypertension may benefit from antihypertensive treatment with a calcium channel blocker and a lipid-lowering statin years after taking the medications, reported a long-term follow-up study in the Lancet. Patients who received amlodipine-based antihypertensive treatment had fewer stroke deaths—independent of blood pressure levels—and patients taking lipid-lowering atorvastatin had fewer cardiovascular deaths.

In the original Anglo-Scandinavian Cardiovascular Outcomes Trial (ASCOT), 19 342 patients with hypertension were randomly assigned to receive amlodipine (with perindopril as required) or to receive atenolol (with or without a diuretic) in the blood pressure-lowering arm (BPLA). The 10 305 participants who also had hyperlipidemia were further randomized to receive atorvastatin or placebo in a lipid-lowering arm (LLA).

The follow-up study reported mortality outcomes of 8580 ASCOT participants 10 years after the trial closed. Within 16 years, 38.3% of participants in this follow-up cohort died. In the LLA, 39.5% of patients who received placebo died compared with 37.3% of those who received atorvastatin. Among patients in the BPLA, there was no difference in all-cause mortality between treatments, but there were fewer deaths from strokes in the amlodipine-based group. In the LLA, significantly fewer cardiovascular deaths occurred among patients assigned to statin than among those assigned to placebo.

However, the investigators didn’t know whether ASCOT participants received antihypertensive and lipid-lowering medications after the trial closed.

Note: Source references are available through embedded hyperlinks in the article text online.

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