Modern drugs can halve stroke and heart attack risk

By Ben Hirschler

STOCKHOLM (Reuters) – More than half of all strokes and
heart attacks in people with high blood pressure can be
prevented by taking a mixture of modern drugs, researchers said
on Sunday.

The largest study of high blood pressure treatment ever
conducted in Europe found newer anti-hypertensive drugs worked
better than older ones and had a dramatic impact on patients’
health, especially when given with a cholesterol pill.

The 19,000-person trial was halted last November because
the drugs proved so much better than conventional treatment,
but final details have only now been presented to clinicians
and published in the Lancet medical journal.

The 5-year trial compared the older drug regime of a beta
blocker and a diuretic with a combination of two newer blood
pressure medicines — Pfizer Inc.’s Norvasc and Aceon/Coversyl
from CV Therapeutics Inc. and Solvay SA.

Norvasc, known generically as amlodipine, is a calcium
channel blocker, while Aceon/Coversyl, or perindopril, is an
ACE inhibitor, originally developed by France’s Servier.

In addition, 10,000 patients were also treated with
Pfizer’s cholesterol-lowering drug Lipitor.

The researchers found the newer blood-pressure drugs
reduced the risk of strokes by about 25 percent, heart attacks
by 15 percent, cardiovascular deaths by 25 percent and new
cases of diabetes by 30 percent compared with standard
treatment.

Adding Lipitor, or atorvastatin, cut the remaining risk
still further, even when patients did not have especially high
cholesterol levels.

Pfizer was the trial’s principal sponsor.

REVIEWING GUIDELINES?

Professor Peter Sever of Imperial College in London,
co-chairman of the study, said the data would cause doctors to
re-evaluate guidelines for using beta blockers as first-line
treatment and highlighted the need for holistic treatment.

“We can now say with confidence that we can reduce the risk
of heart attacks and strokes in the high blood pressure
population by more than 50 percent,” he told Reuters.

“If you could translate that to the millions people with
hypertension that would result in a colossal saving of life.”

In the past, there had been a tendency for doctors to take
a “silo” approach to treating different risk factors, he said,
but avoiding strokes and hearts attacks was all about tackling
interacting risk factors.

The latest findings will re-ignite debate about treating
high blood pressure and may mean international recommendations
for managing the condition need to be reviewed.

Beta blockers, which are mostly off patent and sold
generically, have been standard therapy for high blood
pressure, chest pain and heart failure for years.

In a separate editorial commentary on the study in the
Lancet, Jan Staessen of the University of Leuven, Belgium, said
the study showed the value to society of treating blood
pressure effectively to head off the danger of heart attacks
and stroke.

“Governments and health care insurers will have to accept
that the use of anti-hypertensive drugs cannot be rationed,” he
wrote.