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Effects of Lipid-Lowering and Antihypertensive Treatments in Addition to Healthy Lifestyles in Primary Prevention: An Analysis of the HOPE 3 Trial
Dagenais, Gilles R; Jung, Hyejung; Lonn, Eva; Bogaty, Peter M; Dehghan, Mahshid; Held, Claes; Avezum, Alvaro; Jansky, Petr; Keltai, Matyàs; Leiter, Lawrence A; Lopez-Jaramillo, Patricio; Toff, William D; Bosch, Jackie; Yusuf, Salim.
Afiliação
  • Dagenais, Gilles R; Quebec Heart and Lung University Institute, Laval University. Quebec. CA
  • Jung, Hyejung; Population Health Research Institute, Hamilton General Hospital, McMaster University. Ontario. CA
  • Lonn, Eva; Population Health Research Institute, Hamilton General Hospital, McMaster University. Ontario. CA
  • Bogaty, Peter M; Quebec Heart and Lung University Institute, Laval University. Quebec. CA
  • Dehghan, Mahshid; Population Health Research Institute, Hamilton General Hospital, McMaster University. Ontario. CA
  • Held, Claes; Department of Medical Sciences, Uppsala Clinical Research Center. Uppsala. SE
  • Avezum, Alvaro; Dante Pazzanese Institute of Cardiology. University Santo Amaro. São Paulo. BR
  • Jansky, Petr; University Hospital Motol. Prague. CZ
  • Keltai, Matyàs; Semmelweis University. Budapest. HU
  • Leiter, Lawrence A; University of Toronto. Li Ka Shing Knowledge Institute, St. Michael's Hospital and Departments of Medicine and Nutritional Sciences. Ontario. CA
  • Lopez-Jaramillo, Patricio; Research Department, FOSCAL, Medical School, University of Santander (UDES). Bucaramanga. CO
  • Toff, William D; Department of Cardiovascular Sciences, University of Leicester, and NIHR Leicester Biomedical Research Centre. Leicester. GB
  • Bosch, Jackie; Population Health Research Institute, Hamilton General Hospital, McMaster University. Ontario. CA
  • Yusuf, Salim; Population Health Research Institute, Hamilton General Hospital, McMaster University. Ontario. CA
Journal of the American Heart Association ; 7(15): 008918, July. 2018. tab, graf
Article em En | SES-SP, CONASS, SESSP-IDPCPROD, SES-SP | ID: biblio-1224109
Biblioteca responsável: BR79.1
ABSTRACT

BACKGROUND:

It is not clear whether the effects of lipid-lowering or antihypertensive medications are influenced by adherence to healthy lifestyle factors. We assessed the effects of both drug interventions in subgroups by the number of healthy lifestyle factors in participants in the HOPE-3 (Heart Outcomes Prevention Evaluation) trial. METHODS AND

RESULTS:

In this primary prevention trial, 4 healthy lifestyle factors (nonsmoking status, physical activity, optimal body weight, and healthy diet) were recorded in 12 521 participants who were at intermediate risk of cardiovascular disease (CVD) and were randomized to rosuvastatin, candesartan/hydrochlorothiazide, their combination, or matched placebos. Median follow-up was 5.6 years. The outcome was a composite of CVD events. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. Participants with ≥2 healthy lifestyle factors had a lower rate of CVD compared with those with fewer factors (HR 0.85; 95% CI, 0.73­1.00). Rosuvastatin reduced CVD events in participants with ≥2 healthy lifestyle factors (HR 0.74; 95% CI, 0.62­0.90) and in participants with. < 2 factors HR 0.61; 95% CI, 0.43­0.88). Candesartan/ hydrochlorothiazide tends to reduce CVD only in participants with <2 healthy lifestyle factors (HR 0.78; 95% CI, 0.61­1.00).

CONCLUSIONS:

Healthy lifestyles are associated with lower CVD. Rosuvastatin alone and combined with candesartan/ hydrochlorothiazide is beneficial regardless of healthy lifestyle status; however, the benefit of antihypertensive treatment appears to be limited to patients with less healthy lifestyles.
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Texto completo: 1 Coleções: 06-national / BR Base de dados: CONASS / SES-SP / SESSP-IDPCPROD Assunto principal: Hipertensão / Anti-Hipertensivos Tipo de estudo: Clinical_trials / Prognostic_studies Idioma: En Revista: Journal of the American Heart Association Ano de publicação: 2018 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
Imprimir
XML
Buscar no Google

Texto completo: 1 Coleções: 06-national / BR Base de dados: CONASS / SES-SP / SESSP-IDPCPROD Assunto principal: Hipertensão / Anti-Hipertensivos Tipo de estudo: Clinical_trials / Prognostic_studies Idioma: En Revista: Journal of the American Heart Association Ano de publicação: 2018 Tipo de documento: Article