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Lowering cholesterol, blood pressure, or both to prevent cardiovascular events: results of 8.7 years of follow-up of Heart Outcomes Evaluation Prevention (HOPE)-3 study participants
J. Bosch, EM. Lonn, H. Jung, J. Zhu, L. Liu, P. Lopez-Jaramillo, P. Pais, D. Xavier, R. Diaz, G. Dagenais, A. Dans, A. Avezum, LS. Piegas, A. Parkhomenko, K. Keltai, M. Keltai, K. Sliwa, C. Held, RJG. Peters, BS. Lewis, P. Jansky, K. Yusoff, K....
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, randomizované kontrolované studie, práce podpořená grantem
Grantová podpora
CIHR - Canada
NLK
Free Medical Journals
od 1996 do Před 1 rokem
Open Access Digital Library
od 1996-01-01
- MeSH
- cholesterol MeSH
- dvojitá slepá metoda MeSH
- infarkt myokardu * prevence a kontrola MeSH
- kardiovaskulární nemoci * prevence a kontrola MeSH
- krevní tlak MeSH
- lidé MeSH
- následné studie MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
AIMS: Rosuvastatin (10 mg per day) compared with placebo reduced major adverse cardiovascular (CV) events by 24% in 12 705 participants at intermediate CV risk after 5.6 years. There was no benefit of blood pressure (BP) lowering treatment in the overall group, but a reduction in events in the third of participants with elevated systolic BP. After cessation of all the trial medications, we examined whether the benefits observed during the active treatment phase were sustained, enhanced, or attenuated. METHODS AND RESULTS: After the randomized treatment period (5.6 years), participants were invited to participate in 3.1 further years of observation (total 8.7 years). The first co-primary outcome for the entire length of follow-up was the composite of myocardial infarction, stroke, or CV death [major adverse cardiovascular event (MACE)-1], and the second was MACE-1 plus resuscitated cardiac arrest, heart failure, or coronary revascularization (MACE-2). In total, 9326 (78%) of 11 994 surviving Heart Outcomes Prevention Evaluation (HOPE)-3 subjects consented to participate in extended follow-up. During 3.1 years of post-trial observation (total follow-up of 8.7 years), participants originally randomized to rosuvastatin compared with placebo had a 20% additional reduction in MACE-1 [95% confidence interval (CI), 0.64-0.99] and a 17% additional reduction in MACE-2 (95% CI 0.68-1.01). Therefore, over the 8.7 years of follow-up, there was a 21% reduction in MACE-1 (95% CI 0.69-0.90, P = 0.005) and 21% reduction in MACE-2 (95% CI 0.69-0.89, P = 0.002). There was no benefit of BP lowering in the overall study either during the active or post-trial observation period, however, a 24% reduction in MACE-1 was observed over 8.7 years. CONCLUSION: The CV benefits of rosuvastatin, and BP lowering in those with elevated systolic BP, compared with placebo continue to accrue for at least 3 years after cessation of randomized treatment in individuals without cardiovascular disease indicating a legacy effect. TRIAL REGISTRATION NUMBER: NCT00468923.
Department of Cardiovascular Sciences University of Leicester University Rd Leicester LE1 7RH UK
HCor Hospital do Coração Des Eliseu Guilherme 147 Paraíso São Paulo SP 04004 030 Brazil
Hungarian Institute of Cardiology Semmelweis University Budapest Hungary
Institute of Cardiology Narodnoho Opolchennya St 5 Kiev 03680 Ukraine
Instituto Cardiovascular de Rosario DSR Bv Oroño 440 S2000 Rosario Santa Fe Argentina
Instituto Masira Facultad de Salud Universidad de Santander Calle 70 No 55 210 Bucaramanga Colombia
Leicester Diabetes Centre Gwendolen Rd Leicester LE5 4PW UK
St John's Medical College Sarjarpur Road Bangalore Karnataka 560034 India
St John's Research Institute 100 Feet Rd John Nagar Koramangala Bangalore Karnataka 560034 India
The Department of Cardiology Academic Medical Center Meibergdreef 9 1105 AZ Amsterdam Netherlands
The Department of Medicine 1200 Main St West McMaster University Hamilton ON L8N 3Z5 Canada
The School of Public Health Curtin University Kent St Bentley Perth WA 6102 Australia
Universiti Teknologi Majlis Amansh Rakyat Jalan Ilmu 1 1 40450 Shah Alam Selangor Malaysia
Citace poskytuje Crossref.org
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