Heart Disease Risk Can Be Lowered by Combining Statins with Blood Pressure Drugs
Researchers say prescribing statins along with blood pressure medications improves the survival odds for people with hypertension.
The number of deaths from stroke and heart disease could significantly decrease if people are given statins in combination with medications that lower blood pressure.
That’s the conclusion from researchers in a new study published in the journal Lancet.
Researchers at Queen Mary University London and Imperial College London say that prescribing both statins and blood pressure medications improved patient survival more than a decade after clinical trials were conducted.
“Patients in their mid-60s with high blood pressure were less likely to die from heart disease or stroke by age 75 to 80 if they had taken both calcium channel blocker-based blood pressure-lowering treatment and a statin,” Dr. Ajay K. Gupta, a researcher at the William Harvey Research Institute at Queen Mary University London, said in a press release.
In this research, Gupta and his colleagues used data from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), a legacy study that was established to compare different treatments for hypertension, or high blood pressure.
Between 1998 and 2000, more than 19,000 patients in the United Kingdom, Ireland, and Scandinavia who had high blood pressure were randomly prescribed one of two possible blood pressure-lowering treatments, a calcium channel blocker or a beta-blocker.
Half of the study participants were then randomly selected to receive either a statin or a placebo.
After three years of follow-up, the segment of the trial involving statins was stopped due to the significant success of the treatment in preventing strokes and heart attacks.
The Queen Mary University analysis of the ASCOT trial examined the cause and number of deaths among the 8,580 participants who were based in the United Kingdom.
After 10 years of follow-up, the study participants who were given the calcium channel blocker treatment had 29 percent fewer deaths from stroke compared with those who were given beta-blockers.
After 16 years of follow-up, 3,282 study participants had died. Those who were treated with statins had 15 percent less cardiovascular-related deaths when compared with those who had taken the placebo.
The calcium channel blocker treatment was associated with 21 percent fewer cardiovascular deaths for those considered to have a high cardiovascular risk and who weren’t given statins.
Researchers say the results provide further evidence for the use of a combination of statins to help lower cholesterol and medications for hypertension to lower blood pressure.
“Findings on the blood pressure treatments provides new and important evidence of the importance of not only blood pressure control, but choice of medications combinations. New hypertension guidance has recommended use of two medications, but they have not suggested which is a better combination. Our findings… suggest that this is a better combination for most hypertensive patients, and have potentially a legacy effect,” Gupta told Healthline.
A serious health issue
The American Heart Association estimates 103 million adults in the United States have high blood pressure.
That’s almost half of all adults in the country.
Heart disease is responsible for 1 in every 4 deaths each year, notes the Centers for Disease Control and Prevention (CDC). It’s the number one cause of death in the United States.
Strokes are the fifth-highest cause of death, with 795,000 people expected to have a stroke this year in the United States, estimates the CDC.
Death rates from high blood pressure are on the rise, increasing by almost 11 percent between 2005 and 2015, with the number of deaths rising by 38 percent.
“Hypertension is known as the ‘silent killer,’” Dr. Ezra Amsterdam, a professor of cardiovascular medicine at UC Davis Health, told Healthline.
He says a common misconception people have about hypertension is that if it doesn’t hurt, it can’t be bad. The reality, he says, is quite different.
“Hypertension is a major risk factor for all forms of vascular disease and for atherosclerosis, the major cause of heart attack, the biggest killer in our society. It can also produce stroke, and other vascular diseases such as heart failure, angina, peripheral artery disease, aortic dissection. As the cliché goes: ‘You name it,’” he said.
There are a variety of medications available that can lower blood pressure. Prescriptions differ based on patient needs.
“Current guidelines recommend calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and diuretics as preferred first-line medications to treat high blood pressure. These medications work by lowering blood pressure, lowering the risk of heart attacks, heart failure, stroke, renal failure, and premature cardiovascular death,” Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center, told Healthline.
About 56 million people ages 40 and over may need cholesterol-lowering statin medications.
Dr. Andrew Sauer, medical director of the Advanced Heart Failure Program at the University of Kansas Health System, says such medications, as well as blood pressure medications, can be more effective than even lifestyle modifications.
“Statins and most blood pressure medications are generally inexpensive, and for many patients taking these medications, can be more effective over the long term than lifestyle modification alone,” Sauer told Healthline.
“But let’s not forget the importance of lifestyle modification. Regardless, most medications for lowering blood pressure and most statins cost less than $4 per month, so we need to be aggressive in controlling risk factors as this study further suggests,” Sauer said.