Background and aims: To evaluate the long-term effect of simultaneous treatment of hypertension and hypercholesterolemia with angiotensin-converting enzyme (ACE) inhibitors and statins on the incidence of major cardiovascular events (MACE) and other clinical outcomes. Methods and results: We considered data from a subset of Brisighella Heart Study (BHS) partici-pants who were consecutively evaluated in three epidemiological surveys between 2012 and 2020. We excluded normotensive subjects and individuals with a low calculated 10-year CVD risk, hypertensive patients treated with antihypertensive drugs different from ACE inhibitors and patients who changed antihypertensive medications during follow-up. The remaining par-ticipants were divided into four groups depending on whether they were treated with (I) perindopril +/- amlodipine without statin treatment (N. 132), (II) perindopril +/- amlodipine and atorvastatin (N. 132), (III) an ACE inhibitor other than perindopril +/- a calcium-channel blocker without statin therapy (N. 133), (IV) an ACE inhibitor other than perindopril +/- a calcium -channel blocker and statin therapy (N. 145). The long-term (8 years) effects of the different com-bined treatment were compared among the pre-defined groups. Over the follow-up period of 8 years, the proportion of subjects who developed MACE, type 2 diabetes mellitus and hyperurice-mia, and the proportion of subjects needing for the intensification of antihypertensive treatment to improve blood pressure control were statistically different among the predefined groups (P < 0.05). Conclusion: Combined treatment with ACE inhibitors and statins (especially atorvastatin) in hy-pertensive patients seems to significantly reduce the risk of developing CVD in comparison with treatment with ACE inhibitors alone. (c) 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Ital-ian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
Cicero A.F.G., Fogacci F., Rizzoli E., Giovannini M., D'Addato S., Borghi C., et al. (2022). Impact of simultaneous management of hypertension and hypercholesterolemia with ACE inhibitors and statins on cardiovascular outcomes in the Brisighella Heart Study: A 8-year follow-up. NMCD. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, 32(9), 2246-2254 [10.1016/j.numecd.2022.06.017].
Impact of simultaneous management of hypertension and hypercholesterolemia with ACE inhibitors and statins on cardiovascular outcomes in the Brisighella Heart Study: A 8-year follow-up
Cicero A. F. G.;Fogacci F.;Rizzoli E.;D'Addato S.;Borghi C.;Grandi E.;Ventura F.;Coppola P.;Ianniello E.;Soldati M.;Piani F.;Palmisano S.;Landolfo M.;
2022
Abstract
Background and aims: To evaluate the long-term effect of simultaneous treatment of hypertension and hypercholesterolemia with angiotensin-converting enzyme (ACE) inhibitors and statins on the incidence of major cardiovascular events (MACE) and other clinical outcomes. Methods and results: We considered data from a subset of Brisighella Heart Study (BHS) partici-pants who were consecutively evaluated in three epidemiological surveys between 2012 and 2020. We excluded normotensive subjects and individuals with a low calculated 10-year CVD risk, hypertensive patients treated with antihypertensive drugs different from ACE inhibitors and patients who changed antihypertensive medications during follow-up. The remaining par-ticipants were divided into four groups depending on whether they were treated with (I) perindopril +/- amlodipine without statin treatment (N. 132), (II) perindopril +/- amlodipine and atorvastatin (N. 132), (III) an ACE inhibitor other than perindopril +/- a calcium-channel blocker without statin therapy (N. 133), (IV) an ACE inhibitor other than perindopril +/- a calcium -channel blocker and statin therapy (N. 145). The long-term (8 years) effects of the different com-bined treatment were compared among the pre-defined groups. Over the follow-up period of 8 years, the proportion of subjects who developed MACE, type 2 diabetes mellitus and hyperurice-mia, and the proportion of subjects needing for the intensification of antihypertensive treatment to improve blood pressure control were statistically different among the predefined groups (P < 0.05). Conclusion: Combined treatment with ACE inhibitors and statins (especially atorvastatin) in hy-pertensive patients seems to significantly reduce the risk of developing CVD in comparison with treatment with ACE inhibitors alone. (c) 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Ital-ian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
