Monday, 4 April 2016

SPHPM researchers part of global study to find ‘simple’ methods to prevent heart attacks and stroke

SPHPM researchers have led the Australian arm of a worldwide study on heart attack and stroke prevention published in the New England Journal of Medicine this week.

Professor Christopher Reid, a cardiovascular epidemiologist at SPHPM and Co-Director of the Monash Centre of Cardiovascular Research and Education in Therapeutics (CCRET), and Senior Research Fellow John Varigos steered a team of Australian researchers from Monash and Curtin Universities and together they trialled three treatments to prevent heart attacks and strokes which have been proven inexpensive, simple and effective.

The study of over 12,000 people from 21 countries, including Australia, tested whether a statin drug, which lowers cholesterol; and anti-hypertensives, which lower blood pressure or a combination of both prevented death, heart attack and stroke over the next five and a half years.

Three studies, under the name of HOPE-3, or Heart Outcomes Prevention Evaluation-3, were published in the NEJM, and released to coincide with American College of Cardiology Conference in Chicago over the weekend, which Professor Reid is attending.

Professor Reid, commenting from the United States, said there was a significant benefit, a 25-30 per cent reduction in events in the groups receiving a statin alone or a statin with a blood pressure lowering medicine.

“There were also positive trends in those who received the blood pressure lowering treatment alone,’ Professor Reid said.

“Also important is that treatment with a statin was remarkably safe and beneficial in our study, regardless of cholesterol or blood pressure levels, age, gender or ethnicity.”

The HOPE-3 study, partly funded by the National Heart Foundation of Australia found that statins proved to significantly and safely reduce cardiovascular disease (CVD) events by 25 per cent in patients at intermediate risk without CVD.

Antihypertensives did not reduce major CVD events overall in the population studied, but did reduce such events in the group of people with hypertension, but not in those without hypertension.

However, when combined statins and antihypertensives reduced CVD events by 30 per cent—with a 40% benefit in those with hypertension, suggesting that patients with hypertension should not only lower their blood pressure but also consider taking a statin.

The trial included men 55 years of age or older and women 65 years of age or older who had at least one of the following cardiovascular risk factors: elevated waist-to-hip ratio, history of low concentration of high-density lipoprotein cholesterol (HDL), current or recent tobacco use, high blood glucose, family history of premature coronary disease, and mild renal dysfunction.

Heart Foundation National CEO Professor Garry Jennings said the Heart Foundation was proud to support such important work.

“The study illustrates the importance of Australian participation in global trials, as these results are likely to be immediately adapted to Australia,” Professor Jennings said.

“The evidence from our research is that statins are effective and well-tolerated treatments for people at risk of heart disease,” said John Varigos.

The researchers emphasised that while medicines can be life-saving, it doesn’t mean you can ditch physical activity and eating well; and encourage people to be active for at least 30 minutes a day, to eat healthily, be smoke-free and to achieve and maintain a healthy weight.

The study was independently designed by an expert steering committee and conducted by a worldwide academic collaboration. Globally it was funded by the Canadian Institutes of Health Research and AstraZeneca.

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