Residual cardiovascular risk in treated hypertension and hyperlipidaemia: The PRIME Study
Blacher J et al. – Treatment with antihypertensive agents, but not with lipid-lowering agents, was associated with a sizeable residual cardiovascular risk, suggesting that more efficient risk reduction strategies in hypertension should be developed as a priority. Methods- Study of the degree of cardiovascular risk remaining in hypertension and dyslipidaemia pts treated pharmacologically
- Assessment of levels of risk factors achieved that is 'residual cardiovascular risk'
- Use of data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME)
- PRIME subjects: 9649 men age 50–59 yrs, from France and Northern Ireland with 10-yr follow-up
- PRIME tested presence of specific residual cardiovascular risks of coronary heart disease, stroke, total of fatal and non-fatal cardiovascular events and cardiovascular mortality, in pts treated with antihypertensive agents or lipid-lowering agents
Results- In whole cohort, 796 pts developed fatal or non-fatal cardiovascular event
- Antihypertensive drug use at baseline significantly associated with total cardiovascular event risk, but not lipid-lowering drug use, after adjusting for classic risk factors
- Adjusted classic risk factors: age, smoking, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure and diabetes
- Similar results for coronary heart disease, stroke, and cardiovascular death, but neither for total death nor for non-cardiovascular death
- For any cardiovascular endpoint, residual risks did not globally differ by antihypertensive drug class prescribed at baseline
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