Zhou, Z and Chowdhury, EK and Breslin, M and Curtis, AJ and Reid, CM and Nelson, M, Antihypertensive drug class in combination with lipid lowering treatment for primary prevention of cardiovascular disease in the elderly, Heart and Lung, 51 pp. 40-45. ISSN 0147-9563 (2021) [Refereed Article]
© 2021 Elsevier Inc. All rights reserved.
Background: Antihypertensives and lipid-lowering therapy (LLT) are often used concurrently.
Objectives: To determine whether there was a difference in clinical outcomes when older patients with LLT were prescribed angiotensin-converting-enzyme-inhibitors (ACE-Is) compared with diuretics.
Methods: This analysis included 648 LLT older users free of cardiovascular disease (CVD) from a trial comparing ACE-I versus diuretic-based therapy. Comparisons were made between LLT+ACE-I (n = 335) and LLT+diuretic groups (n = 313) using multivariable Cox proportional-hazard models. Primary endpoints were all-cause and CVD mortality (in-trial [4.1-year]+post-trial [6.9-year]) and secondary endpoints (in-trial) were the composite of all-cause mortality and first CVD events and its components, CVD mortality and incident diabetes.
Results: There were no significant differences between the two groups for the primary endpoints over the in-trial plus post-trial follow-up, nor was there a difference for any secondary outcomes over the in-trial follow-up.
Conclusions: The LLT+ACE-I and LLT+diuretic combinations showed similar effects in CVD-free older individuals. Randomised trials are needed to provide conclusive evidence.
|Item Type:||Refereed Article|
|Keywords:||liplid-lowering, blood pressure, primary prevention, cardiovascular disease|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Efficacy of medications|
|UTAS Author:||Zhou, Z (Dr Zhen Zhou)|
|UTAS Author:||Breslin, M (Dr Monique Breslin)|
|UTAS Author:||Nelson, M (Professor Mark Nelson)|
|Deposited By:||Menzies Institute for Medical Research|
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