| Literature DB >> 26013360 |
Nicholas J Wald1, Joan K Morris.
Abstract
Entities:
Year: 2015 PMID: 26013360 PMCID: PMC4643548 DOI: 10.1007/s10654-015-0035-4
Source DB: PubMed Journal: Eur J Epidemiol ISSN: 0393-2990 Impact factor: 8.082
Estimates relating to the prevention of a first myocardial infarction (MI) or stroke (“disorder”) in people taking polypill from specified ages
| Taking polypill from specified age to age 99 | Proportion of people who will have first MI or stroke in the absence of treatment (%) | Proportion of people who will have first MI or stroke while taking polypill (%) | Relative risk reduction (%) | Absolute annual risk reduction (%) | Proportion of people who benefit (HBp) (%) | Among those who benefit: Average years of life gained without an MI or stroke (HBag) |
|---|---|---|---|---|---|---|
| 50 | 34 | 16 | 53 | 0.53 | 34 | 7.7 |
| 60 | 33 | 16 | 52 | 0.69 | 33 | 6.5 |
| 70 | 32 | 16 | 51 | 0.95 | 32 | 5.1 |
| 80 | 29 | 15 | 49 | 1.41 | 29 | 3.4 |
Estimates relating to the prevention of a first myocardial infarction (MI) or stroke in individuals aged 50 and above according to specified daily salt reduction
| Salt reduction (g/day) | Proportion of people who will have first MI or stroke in the absence of treatment (%) | Proportion of people who will have first MI or stroke with a reduced salt intake (%) | Relative risk reduction (%) | Absolute annual risk reduction (%) | Proportion of people who benefit (HBp) (%) | Among those who benefit: average years of life gained without an MI or stroke (HBag) |
|---|---|---|---|---|---|---|
| 1.5 | 34 | 32 | 4 | 0.04 | 34 | 0.7 |
| 3.0 | 34 | 31 | 8 | 0.09 | 34 | 1.4 |
| 4.5 | 34 | 30 | 12 | 0.13 | 34 | 2.0 |
| 6.0 | 34 | 28 | 16 | 0.17 | 34 | 2.6 |
The two measures of health benefit in people aged 50 and over according to different preventive interventions to reduce the risk of a first myocardial infarction (MI) or stroke
| Reducing salt by 6 g/day | Taking simvastatin 20 mg daily from age 50 | Taking three blood-pressure-lowering drugs at half standard dose daily from age 50 | Taking polypill daily from age 50 (all four drugs) | Reducing salt by 6 g/day and taking polypill daily from age 50 | |
|---|---|---|---|---|---|
| Proportion who benefit (HBp) | 34 % | 34 % | 34 % | 34 % | 34 % |
| Among these: average years of life gained without an MI or stroke (HBag) | 2.6 | 3.7 | 5.5 | 7.7 | 8.7 |
Age-specific relative risk estimates
| Age taking polypill | Relative risk of a first stroke on daily polypilla | Relative risk of a first myocardial infarction on daily polypilla |
|---|---|---|
| 50 | 0.26 | 0.13 |
| 60 | 0.28 | 0.23 |
| 70 | 0.34 | 0.32 |
| 80 | 0.44 | 0.36 |
| 90+ | 0.51 | 0.38 |
aPolypill contained amlodipine 2.5 mg, losartan 25 mg, hydrochlorothiazide 12.5 mg and simvastatin 20 mg
Average relative risk reductions (%) of a first myocardial infarction or stroke according to age at starting polypill and years of follow-up
| Years of follow-up | Age starting to take polypill daily | |||
|---|---|---|---|---|
| 50 | 60 | 70 | 80 | |
| 10 | 78 | 71 | 63 | 54 |
| 20 | 73 | 64 | 55 | 49 |
| 30 | 66 | 57 | 51 | – |
| 40 | 58 | 52 | – | – |
| 50 | 53 | – | – | – |
Reduction in systolic blood pressure (SBP) and age-specific relative risk estimates of a first myocardial infarct (MI) or stroke according to age and salt intake reduction
| Age | 1.5 g/day | 3.0 g/day | 4.5 g/day | 6 g/day | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SBP reduction (mmHg) | Relative risk of a first MI | Relative risk of a first stroke | SBP reduction (mmHg) | Relative risk of a first MI | Relative risk of a first stroke | SBP reduction (mmHg) | Relative risk of a first MI | Relative risk of a first stroke | SBP reduction (mmHg) | Relative risk of a first MI | Relative risk of a first stroke | |
| 45 | 1.7 | 0.93 | 0.91 | 3.3 | 0.87 | 0.83 | 4.9 | 0.82 | 0.75 | 6.6 | 0.76 | 0.69 |
| 55 | 2.3 | 0.92 | 0.88 | 4.6 | 0.85 | 0.77 | 6.9 | 0.79 | 0.67 | 9.2 | 0.73 | 0.60 |
| 65 | 2.6 | 0.94 | 0.90 | 5.2 | 0.88 | 0.82 | 7.7 | 0.82 | 0.74 | 10.3 | 0.77 | 0.67 |
| 75 | 2.7 | 0.95 | 0.92 | 5.4 | 0.90 | 0.85 | 8.1 | 0.85 | 0.78 | 10.8 | 0.81 | 0.72 |
| 85 | 2.7 | 0.96 | 0.95 | 5.5 | 0.92 | 0.90 | 8.2 | 0.89 | 0.86 | 11.0 | 0.85 | 0.82 |