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Blood-pressure and cholesterol lowering in persons without cardiovascular disease

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dc.contributor.authorYusuf, Salimspa
dc.contributor.authorLonn, Evaspa
dc.contributor.authorPais, Premspa
dc.contributor.authorBosch, Jackiespa
dc.contributor.authorLopez-Jaramillo, Patriciospa
dc.contributor.authorZhu, Junspa
dc.contributor.authorXavier, Denisspa
dc.contributor.authorAvezum, Alvarospa
dc.contributor.authorLeiter, Lawrence A.spa
dc.contributor.authorPiegas, Leopoldo S.spa
dc.contributor.authorParkhomenko, Alexanderspa
dc.contributor.authorKeltai, Matyasspa
dc.contributor.authorKeltai, Katalinspa
dc.contributor.authorSliwa, Karenspa
dc.contributor.authorChazova, Irinaspa
dc.contributor.authorPeters, Ron J.G.spa
dc.contributor.authorHeld, Claesspa
dc.contributor.authorYusoff, Khalidspa
dc.contributor.authorLewis, Basil S.spa
dc.contributor.authorJansky, Petrspa
dc.contributor.authorKhunti, Kamleshspa
dc.contributor.authorToff, William D.spa
dc.contributor.authorReid, Christopher M.spa
dc.contributor.authorVarigos, Johnspa
dc.contributor.authorAccini, Jose Luisspa
dc.contributor.authorMcKelvie, Robertspa
dc.contributor.authorPogue, Janicespa
dc.contributor.authorJung, Hyejungspa
dc.contributor.authorLiu, Lishengspa
dc.contributor.authorDiaz, Rafaelspa
dc.contributor.authorDans, Antoniospa
dc.contributor.authorDagenais, Gillesspa
dc.contributor.authorHOPE-3 Investigatorsspa
dc.date.accessioned2019-07-24T16:33:32Zspa
dc.date.available2019-07-24T16:33:32Zspa
dc.date.issued2016-04-02spa
dc.description12 p.spa
dc.description.abstractBACKGROUND Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase the risk of cardiovascular disease. Lowering both should reduce the risk of cardiovascular events substantially. METHODS In a trial with 2-by-2 factorial design, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to rosuvastatin (10 mg perday) or placebo and to candesartan (16 mg per day) plus hydrochlorothiazide (12.5 mg per day) or placebo. In the analyses reported here, we compared the 3180 participants assigned to combined therapy (with rosuvastatin and the two antihypertensive agents) with the 3168 participants assigned to dual placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The median follow-up was 5.6 years. RESULTS The decrease in the LDL cholesterol level was 33.7 mg per deciliter (0.87 mmol per liter) greater in the combined-therapy group than in the dual-placebo group, and the decrease in systolic blood pressure was 6.2 mm Hg greater with combined therapy than with dual placebo. The first coprimary outcome occurred in 113 participants (3.6%) in the combined-therapy group and in 157 (5.0%) in the dual-placebo group (hazard ratio, 0.71; 95% confidence interval [CI], 0.56 to 0.90; P=0.005). The second coprimary outcome occurred in 136 participants (4.3%) and 187 participants (5.9%), respectively (hazard ratio, 0.72; 95% CI, 0.57 to 0.89; P=0.003). Muscle weakness and dizziness were more common in the combined-therapy group than in the dual-placebo group, but the overall rate of discontinuation of the trial regimen was similar in the two groups. CONCLUSIONS The combination of rosuvastatin (10 mg per day), candesartan (16 mg per day), and hydrochlorothiazide (12.5 mg per day) was associated with a significantly lower rate of cardiovascular events than dual placebo among persons at intermediate risk who did not have cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; ClinicalTrials.gov number, NCT00468923.)eng
dc.format.mimetypeapplication/pdfspa
dc.identifier.doi10.1056/NEJMoa1600177spa
dc.identifier.issn1533-4406spa
dc.identifier.issn0028-4793spa
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/3458spa
dc.language.isoengspa
dc.relation.ispartofNew England Journal of Medicineeng
dc.rightsDerechos Reservados - New England Journal of Medicine, 2016spa
dc.rights.accessrightsinfo:eu-repo/semantics/closedAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://pdfs.semanticscholar.org/5673/95a89b91b2364dd49deb534e92047b9a0fd6.pdf?_ga=2.229909532.1207694793.1563984236-1782380525.1556661431eng
dc.sourcehttps://www.nejm.org/doi/pdf/10.1056/NEJMx180035?articleTools=trueeng
dc.subject.proposalBlood pressureeng
dc.subject.proposalCholesterol loweringeng
dc.subject.proposalCardiovascular diseaseeng
dc.titleBlood-pressure and cholesterol lowering in persons without cardiovascular diseaseeng
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_14cbspa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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