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ACP Journal Club |19 July 2016

Adding candesartan-HCTZ to rosuvastatin increased adverse events but not benefits in patients at intermediate CV risk

Charles B. Eaton MD, MS

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Yusuf S, Lonn E, Pais P, et al. Blood-pressure and cholesterol lowering in persons without cardiovascular disease. N Engl J Med. 2016;374:2032-43. 27039945

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Cardiology:

In patients at intermediate cardiovascular (CV) risk, does rosuvastatin plus combination candesartan–hydrochlorothiazide (HCTZ) reduce major CV events?
Randomized, placebo-controlled, 2 x 2 factorial trial (Heart Outcomes Prevention Evaluation [HOPE]-3 trial). ClinicalTrials.gov NCT00468923.
Concealed.*
Blinded* (patients, clinicians, outcome assessors, and steering committee).
Median 5.6 years.
228 clinical centers in 21 countries on 6 continents.
12 705 men ≥ 55 years of age and women ≥ 65 years of age who had ≥ 1 CV risk factor (elevated waist-to-hip ratio, dysglycemia, mild renal dysfunction, recent or current use of tobacco, previous low high-density lipoprotein cholesterol level, and family history of premature coronary disease) or were ≥ 60 years of age with ≥ 2 risk factors; and adhered to a 4-week run-in phase with blood pressure and cholesterol treatments and had no unacceptable adverse events. Exclusion criteria included CVD or indications for, or contraindications to, statins, angiotensin-receptor blockers, angiotensin-converting enzyme inhibitors, or thiazide diuretics. Mean age of participants was 66 y and 54% were men.
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Eaton MD CB. Adding candesartan-HCTZ to rosuvastatin increased adverse events but not benefits in patients at intermediate CV risk. Ann Intern Med. ;165:JC8. doi: 10.7326/ACPJC-2016-165-2-008

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Published: Ann Intern Med. 2016;165(2):JC8.

DOI: 10.7326/ACPJC-2016-165-2-008

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2016 American College of Physicians
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