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Residual cardiovascular risk in treated hypertension and hyperlipidaemia: The PRIME Study
Journal of Human Hypertension, 06/03/09

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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