Combining blood pressure and cholesterol drugs could prevent stroke better

In a recent study, researchers found that combining medication that lowers blood pressure with medication that lowers cholesterol could reduce first-time strokes by 44%.

Seventy-five percent of strokes are first-time strokes.

The findings come from the Heart Outcomes Prevention Evaluation Study, a large, international study focused on heart disease and stroke prevention.

High blood pressure and high cholesterol both increase the risk for stroke, the fifth leading cause of death in America.

However, it’s not known whether combining drugs that lower blood pressure and cholesterol levels can protect individuals from a stroke.

The current study involved 12,705 participants from 21 countries.

The average age of the participants was 66 years; 46 percent were women, and 166 strokes occurred during an average follow-up of 5.6 years.

At the start of the study, the average blood pressure was 138/82 mm Hg. A normal blood pressure reading is around 120/80 mm Hg.

The study shows that individually, drugs that lower blood pressure or cholesterol do indeed reduce stroke risk, but when combined, they offer even greater protection.

The researchers found that taking daily doses of two blood pressure drugs (fixed dose candesartan and hydrochlorothiazide) along with a cholesterol-lowering drug (low-dose rosuvastatin), proved to be the most effective, cutting first-time strokes by 44% among patients at intermediate risk for heart disease.

For those with very high blood pressure — readings 143.5 mm Hg or higher — taking 16 milligrams of candesartan plus 12.5 milligrams of hydrochlorothiazide every day reduced stroke by 42%.

Compared with placebo, stroke was reduced by 30% among participants taking daily doses of 10 milligrams of rosuvastatin.

These results indicate that to prevent stroke in those at moderate risk, blood pressure lowering plus cholesterol-lowering should be considered in those with elevated blood pressure, and cholesterol-lowering should definitely be considered for all/

These are existing drugs that are well-tolerated, have strong safety profiles and it is easy for patients to stick with them.

Based on these findings, the researchers are now looking at developing a single pill that produces the same effects as taking multiple pills that lower both blood pressure and cholesterol.

The lead study author is Jackie Bosch, Ph.D. from the McMaster University in Hamilton, Ontario, Canada.

The study was presented at the American Stroke Association’s International Stroke Conference 2018.

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