Combining drugs for BP, cholesterol more effective in stroke prevention

Antihypertensive drugs and statins can each lower a patient’s risk of stroke but taking both medications simultaneously is even more protective, according to research presented Jan. 25 at the International Stroke Conference in Los Angeles.

Lead study author Jackie Bosch, PhD, and colleagues studied 12,705 people from 21 countries and evaluated the level to which different drug combinations reduced the risk of first-time stroke. Participants were 66 years old on average, 46 percent women and were followed for a mean 5.6 years. They were considered at intermediate risk for heart disease at baseline.

The researchers found:

• Taking daily doses of two blood pressure drugs—fixed dose candesartan and hydrochlorothiazide—along with a low dose of the cholesterol-lowering rosuvastatin reduced first-time strokes by 44 percent.
• For participants with systolic blood pressure at 143.5 millimeters of mercury or higher, taking 16 milligrams of candesartan plus 12.5 mg of hydrochlorothiazide every day reduced stroke by 42 percent.
• Stroke was reduced by 30 percent for participants taking 10 mg rosuvastatin each day versus a placebo.

“These results indicate that to prevent stroke in those at moderate risk, blood pressure lowering plus cholesterol-lowering should be considered in those with elevated blood pressure, and cholesterol-lowering should definitely be considered for all,” Bosch said in a press release. “These are existing drugs that are well-tolerated, have strong safety profiles and it is easy for patients to stick with them.”

Bosch noted researchers are attempting to develop a single pill that produces the same cholesterol-lowering and blood-pressure lowering effects as taking multiple medications.

Daniel T. Lackland, DrPH, said the study’s results weren’t surprising, but they added specific statistics to the effect blood pressure and cholesterol can have on stroke risk.

“I don't think this is totally new information. It's just kind of a little bit more refined information,” said Lackland, a professor of medicine and Director of Graduate Training at the Medical University of South Carolina. “If … you're at a risk level or a higher risk level for either heart disease or stroke, then typically this is going to be a message that's going to be consistent with you being treated both with anti-hypertension medications as well as cholesterol medications."