A global study has found that a combination of medications given to a patient before they develop high-risk triggers of heart disease, can reduce their risk of developing a heart condition by more than a third.
- The research was broken into three studies, named HOPE-3
- Prior to the study researchers did not know if there was any benefit from targeting people at intermediate risk
- More than 12,000 patients around the world took part in the five-year study
The researchers found that by combining statin drugs with anti-hypertensives, patients with intermediate risk levels significantly reduced their chance of developing a stroke or having a heart attack.
Professor Christopher Reid from Curtin University led the Australian team of five researchers involved in the worldwide study.
“These findings fill a gap in the literature,” he said.
“We weren’t really sure prior to the HOPE-3 study as to whether or not we got any benefit from targeting those people at intermediate risk.”
The study looked at people who had an intermediate, or medium, risk of heart attack or stoke, such as higher blood pressure or cholesterol levels.
The drug cocktail consisted of statin drugs, which are medications that lower cholesterol, and anti-hypertensives, which are medications that help to lower blood pressure.
“It was almost up to around a 30 to 40 per cent reduction in new onset heart attack and stroke,” Professor Reid said.
“This is one of the first studies looking at the concept of a polypill, or combination treatment, directed toward those major risk factors for heart attacks and strokes, that’s blood pressure and elevated lipid levels,” Professor Reid said.
The research was broken into three studies, named Heart Outcomes Prevention Evaluation-3, or HOPE-3 for short.
One study looked at lowering blood pressure, the second at lowering cholesterol, and the third examined how patients responded to receiving both treatments at the same time.
More than 12,000 patients around the world took part in the five-year study.
“This wasn’t just done in one isolated population, there were nearly 30-odd countries around the world involved,” Professor Reid said.
“We didn’t see any difference, and this is important, whether people came from India, or from China, or from Australia, the effects were very similar across all different population groups.
“That’s really important when we’re talking about really a global strategy to reduce future heart attacks and strokes.”
Benefits outweigh the risks
The Australian Heart Foundation helped fund the research.
The chief medical advisor of the foundation, Professor Garry Jennings, said the findings were significant, but that they should not necessarily lead to mass treatment for people with medium-level risk factors.
“Some people will interpret this, as they have been for some time, in saying that there’s a certain portion of the population, of a certain age and a certain level of risk, that should just all be on blood pressure lowering and statin and aspirin or other kinds of medications,” he said.
“We certainly wouldn’t go that far based on this evidence.”
Professor Jennings said no one study would cause an about-turn in the way medical recommendations were made.
“I think what it will do is give people confidence about using these drugs, particularly statins, because that’s always a question of the balance between risk and benefit,” he said.
“Here it seems the benefits are such that the risks are not significant, numerically at least, in people with a moderate risk,” he said.
For now, the advice from the foundation to keep physically active still remains the best prevention for heart disease.
“Our primary message is not going to change,” Mr Jennings said.
“That’s remain physically active, eat well, try to avoid putting on weight, get yourself checked for absolute risk and for diabetes and other things.
“That’s going to give the best community and public health outcome we can hope for.”
The study was published in The New England Journal of Medicine.