医学
中止
联合疗法
安慰剂
吲达帕胺
危险系数
他汀类
培哚普利
内科学
阿司匹林
心肌梗塞
血压
心脏病学
临床试验
重症监护医学
阿托伐他汀
随机对照试验
置信区间
替代医学
病理
作者
Nelson Wang,Katie Harris,John Chalmers,Stephen Harrap,Giuseppe Mancia,Michel Marre,Neil R Poulter,Christophe Tzourio,Bryan Williams,Sophia Zoungas,Mark Woodward,Anthony Rodgers
标识
DOI:10.1097/hjh.0000000000002862
摘要
To assess the effects of combination BP lowering on cardiovascular events and mortality in the presence of aspirin and/or statin therapy in a combined analysis of the ADVANCE and PROGRESS trials.We conducted an analysis of 14 682 participants allocated combination therapy with perindopril and indapamide or placebo followed up for a mean of 4.2 years. Participants were stratified into four groups defined by background use of medications at baseline: statin, aspirin, both or neither. Linear mixed effect models were used to assess differences in BP and Cox proportional hazard models were used to estimate the risks of major cardiovascular events, all-cause mortality and treatment discontinuation.At baseline, 14% of patients were on both aspirin and statin, 35% on aspirin, 9% on statins and 42% on neither aspirin/statins. Compared with placebo, combination BP therapy reduced mean SBP by 5.7 mmHg in ADVANCE and 12.1 mmHg in PROGRESS, with no difference (P > 0.447) between patients by baseline use of aspirin/statin. Combination BP therapy reduced the risk of major cardiovascular events (hazard ratio 0.78, 95% CI 0.71-0.86), with no significant difference (P = 0.600) between aspirin/statin subgroups. Rates of treatment discontinuation were similar with combination BP therapy compared with placebo (18.4 versus 18%), with no evidence of difference across the subgroups (P = 0.340).BP lowering with perindopril and indapamide reduces the risk of major cardiovascular events independent of baseline use of aspirin and/or statins.
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