Key result
Combination blood pressure lowering with perindopril and indapamide reduced the risk of major cardiovascular events (HR 0.78; 95% CI 0.71-0.86), independent of baseline aspirin or statin use.
Why the study?
The study was designed to assess the effects of combination blood pressure lowering on cardiovascular events and mortality in the presence of background aspirin and/or statin therapy.
Does combination therapy with perindopril and indapamide reduce major cardiovascular events in patients regardless of background statin and aspirin therapy?
Meta-Analysis (n=14,682)
Does combination therapy with perindopril and indapamide reduce major cardiovascular events in patients regardless of background statin and aspirin therapy?
Hazard Ratio: 0.78 (95% CI 0.71–0.86)
Combination blood pressure lowering with perindopril and indapamide reduces major cardiovascular events regardless of concurrent aspirin or statin use.
Supports adding perindopril-indapamide regardless of aspirin or statin use; confirms benefit independent of background therapy.
OBJECTIVES: To assess the effects of combination BP lowering on cardiovascular events and mortality in the presence of aspirin and/or statin therapy in a combined analysis of the ADVANCE and PROGRESS trials. METHODS: We conducted an analysis of 14 682 participants allocated combination therapy with perindopril and indapamide or placebo followed up for a mean of 4.2 years. Participants were stratified into four groups defined by background use of medications at baseline: statin, aspirin, both or neither. Linear mixed effect models were used to assess differences in BP and Cox proportional hazard models were used to estimate the risks of major cardiovascular events, all-cause mortality and treatment discontinuation. RESULTS: At baseline, 14% of patients were on both aspirin and statin, 35% on aspirin, 9% on statins and 42% on neither aspirin/statins. Compared with placebo, combination BP therapy reduced mean SBP by 5.7 mmHg in ADVANCE and 12.1 mmHg in PROGRESS, with no difference (P > 0.447) between patients by baseline use of aspirin/statin. Combination BP therapy reduced the risk of major cardiovascular events (hazard ratio 0.78, 95% CI 0.71-0.86), with no significant difference (P = 0.600) between aspirin/statin subgroups. Rates of treatment discontinuation were similar with combination BP therapy compared with placebo (18.4 versus 18%), with no evidence of difference across the subgroups (P = 0.340). CONCLUSION: BP lowering with perindopril and indapamide reduces the risk of major cardiovascular events independent of baseline use of aspirin and/or statins.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2021) reported a meta-analysis. perindopril and indapamide vs. placebo was evaluated on major cardiovascular events (HR 0.78, 95% CI 0.71-0.86). Combination blood pressure lowering with perindopril and indapamide reduced the risk of major cardiovascular events (HR 0.78; 95% CI 0.71-0.86), independent of baseline aspirin or statin use.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: