Fixed-Dose Combination Therapies Reduce Cardiovascular Risk

TUESDAY, Aug. 31, 2021 (HealthDay News) — Fixed-dose combination treatment consisting of blood pressure-lowering medications and a statin yields reduction in cardiovascular risk, according to research published online Aug. 29 in The Lancet to coincide with the European Society of Cardiology Congress 2021: The Digital Experience, held virtually from Aug. 27 to 30.

Philip Joseph, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted an individual participant data meta-analysis of three large randomized controlled trials with 18,162 participants for primary cardiovascular disease prevention. Trials assessing a fixed-dose combination strategy of at least two blood pressure-lowering agents plus a statin (with or without aspirin) compared to a control were included.

The researchers found that the primary outcome (time to first occurrence of a composite of cardiovascular death, myocardial infarction, stroke, or arterial revascularization) occurred in 3.0 and 4.9 percent of patients in the combination strategy and control groups, respectively (hazard ratio, 0.62). Reductions were also seen for separate components of the primary outcome: 0.52, 0.54, 0.59, and 0.65 for myocardial infarction, revascularization, stroke, and cardiovascular death, respectively. In the analyses of fixed-dose combination strategies with and without aspirin, significant reductions were seen in the primary outcome and its components, with greater reductions for strategies including aspirin. Similar treatment effects were seen at different lipid and blood pressure levels and in the presence or absence of diabetes, smoking, or obesity.

“The largest reductions in cardiovascular disease risk are observed for formulations that combine blood pressure lowering medications, a statin, and aspirin,” the authors write. “Implementation of such treatment strategies should be considered in primary cardiovascular disease prevention.”

Several authors disclosed financial ties to the pharmaceutical industry.

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