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Simple methods to prevent heart attacks and stroke

Australian researchers part of global study to find ‘simple’ methods to prevent heart attacks and stroke


Australians researchers have been part of an international contingent of researchers who have shown three simple and relatively inexpensive treatments to prevent heart attacks and stroke worldwide have proven effective.


The study of over 12,000 people from 21 countries, including Australia, tested whether a statin drug, which lowers cholesterol; and anti-hypertensives, which lower blood pressure or a combination of both prevented death, heart attack and stroke over the next 5 1/2 years.


The Australian investigators (a team of five from Sydney, Canberra, Dubbo, Melbourne and Perth) were led by Professor Christopher Reid and Mr John Varigos from Monash and Curtin Universities and were partly funded by the National Heart Foundation of Australia.


Three studies, under the name of HOPE-3, or Heart Outcomes Prevention Evaluation-3, were published in the New England Journal of Medicine, and released to coincide with American College of Cardiology Conference in Chicago over the weekend, which Prof Reid is attending.


Prof Reid, commenting from the USA, said there was a significant benefit, a 25-30% reduction in events in the groups receiving a statin alone or a statin with a blood pressure lowering medicine.  


“There were also positive trends in those who received the blood pressure lowering treatment alone,’ Prof Reid said.


“Also important is that treatment with a statin was remarkably safe and beneficial in our study, regardless of cholesterol or blood pressure levels, age, gender or ethnicity.”

 

The studies findings:

    Statins proved to significantly and safely reduce CVD events by 25 per cent in patients at intermediate risk without CVD.

    Antihypertensives did not reduce major CVD events overall in the population studied, but did reduce such events in the group of people with hypertension, but not in those without hypertension.

    When combined, statins and antihypertensives reduced CVD events by 30 per cent—with a 40% benefit in those with hypertension, suggesting that patients with hypertension should not only lower their BP but also consider taking a statin.


The trial included men 55 years of age or older and women 65 years of age or older who had at least one of the following cardiovascular risk factors: elevated waist-to-hip ratio, history of low concentration of high-density lipoprotein cholesterol (HDL), current or recent tobacco use, high blood glucose, family history of premature coronary disease, and mild renal dysfunction.


Heart Foundation National CEO Professor Garry Jennings said the Heart Foundation was proud to support such important work.


“The study illustrates the importance of Australian participation in global trials, as these results are likely to be immediately adapted to Australia,” Prof Jennings said.


“We estimate that 2.1 million Australians fulfil the present guidelines for treatment with statin as they are at high risk of having a heart event. However, future guideline committees might consider expanding this eligibility to people at moderate risk of having a heart attack or stroke.


“The results support the Heart Foundation’s recommendations of treating a person based on their overall risk, rather than cholesterol or blood pressure in isolation.  


“This is yet more evidence that statins are effective and well tolerated treatments for people at risk of heart disease.”  


Prof Jennings added, while we know medicines can be life-saving, it doesn’t mean you can ditch physical activity and eating well. “We encourage all Australians to be active for at least 30 minutes a day, to eat healthily, be smoke-free and to achieve and maintain a healthy weight.”


The study was independently designed by an expert steering committee and conducted by a worldwide academic collaboration.  Globally it was funded by the Canadian Institutes of Health Research and AstraZeneca.  

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