Daniel E McNavish1, Charles A German2, Michael D Shapiro3. 1. Department of Internal Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA. 2. Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA. 3. Center for Prevention of Cardiovascular Disease, Section On Cardiovascular Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA. mdshapir@wakehealth.edu.
Abstract
PURPOSE OF REVIEW: To review the milestone trials and recent literature supporting statin therapy for prevention of atherosclerotic cardiovascular disease (ASCVD) and to provide rationale for more generalized use of statin therapy among patients treated for hypertension. RECENT FINDINGS: Hypertension is a leading modifiable risk factor for ASCVD worldwide. Randomized controlled trial evidence supports initiation of antihypertensive medication for stage 2 hypertension regardless of ASCVD risk. The HOPE-3 trial tested statin therapy in intermediate-risk individuals (defined as an annual risk of major cardiovascular events of approximately 1%) for primary prevention of ASCVD and reported significant reductions in cardiovascular events in all statin treatment arms, with the greatest benefit observed in patients in the highest tertile of systolic blood pressure. Based on the current data, patients with stage 2 hypertension with an indication for antihypertensive therapy may benefit from the addition of statin therapy in the primary prevention setting. Patients with hypertension have an elevated risk for ASCVD that appears to be modifiable beyond implementation of antihypertensive therapy. The addition of statin therapy in patients treated with antihypertensive therapy may further help to lower risk of future cardiovascular events.
PURPOSE OF REVIEW: To review the milestone trials and recent literature supporting statin therapy for prevention of atherosclerotic cardiovascular disease (ASCVD) and to provide rationale for more generalized use of statin therapy among patients treated for hypertension. RECENT FINDINGS: Hypertension is a leading modifiable risk factor for ASCVD worldwide. Randomized controlled trial evidence supports initiation of antihypertensive medication for stage 2 hypertension regardless of ASCVD risk. The HOPE-3 trial tested statin therapy in intermediate-risk individuals (defined as an annual risk of major cardiovascular events of approximately 1%) for primary prevention of ASCVD and reported significant reductions in cardiovascular events in all statin treatment arms, with the greatest benefit observed in patients in the highest tertile of systolic blood pressure. Based on the current data, patients with stage 2 hypertension with an indication for antihypertensive therapy may benefit from the addition of statin therapy in the primary prevention setting. Patients with hypertension have an elevated risk for ASCVD that appears to be modifiable beyond implementation of antihypertensive therapy. The addition of statin therapy in patients treated with antihypertensive therapy may further help to lower risk of future cardiovascular events.
Authors: Diane E Bild; David A Bluemke; Gregory L Burke; Robert Detrano; Ana V Diez Roux; Aaron R Folsom; Philip Greenland; David R Jacob; Richard Kronmal; Kiang Liu; Jennifer Clark Nelson; Daniel O'Leary; Mohammed F Saad; Steven Shea; Moyses Szklo; Russell P Tracy Journal: Am J Epidemiol Date: 2002-11-01 Impact factor: 4.897
Authors: G D Friedman; G R Cutter; R P Donahue; G H Hughes; S B Hulley; D R Jacobs; K Liu; P J Savage Journal: J Clin Epidemiol Date: 1988 Impact factor: 6.437