STOCKHOLM, Sweden, September 4 /PRNewswire/ --
     - Largest European Study of High Blood Pressure Published
     - Issued on Behalf of the Executive Committee of the Anglo-Scandinavian
 Cardiac Outcomes Trial (ASCOT)
     Most strokes and heart attacks in people with high blood pressure can be
 abolished by simply combining effective, modern blood pressure lowering drugs
 with treatment to reduce cholesterol.
     The success of this treatment strategy has been shown for the first time
 in the largest study of high blood pressure treatment ever conducted in
 Europe - the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) - which was
 presented at the congress of the European Society of Cardiology today and is
 published online in The Lancet.
     ASCOT included more than 19,000 men and women with high blood pressure
 who were at a moderate risk of strokes and heart attacks. To control their
 blood pressure, they received either the newer drugs - a calcium antagonist,
 amlodipine and the ACE inhibitor, perindopril - or a traditional combination
 of a beta-blocker, atenolol and a diuretic. Additionally, 10,000 patients
 were also treated with the cholesterol lowering drug atorvastatin or a
 placebo (dummy pill). This is the only major European study to-date to
 combine these two treatment strategies.
     Co-Chairman of the ASCOT Steering Committee, Professor Peter Sever,
 Professor of Clinical Pharmacology and Therapeutics, Imperial College London,
 International Centre for Circulatory Health, London, UK, said: "The patients
 treated in ASCOT were those generally seen in everyday practice. They had
 high blood pressure plus three additional risk factors, e.g. aged over 55,
 male gender, smoker. They were seen as being at moderate risk. Compared with
 patients receiving standard blood pressure lowering therapy of a beta-blocker
 and diuretic, the combination of the contemporary blood pressure lowering
 drugs, amlodipine and perindopril, plus effective lowering of cholesterol
 abolished about half the risk of strokes and heart attacks - the most
 important causes of death in millions of men and women with high blood
 pressure."
     The final results of ASCOT, which was conducted in the UK, Ireland and
 the Nordic countries, showed that the combination of newer blood pressure
 lowering drugs reduced the risk of strokes by about 25%, coronaries by 15%,
 cardiovascular deaths by 25% and new cases of diabetes by 30% compared with
 the standard treatment.
     The addition of the cholesterol lowering drug, atorvastatin, still
 further reduced the remaining risk irrespective of the patient's original
 cholesterol level. Indeed, the ASCOT patients only had average or below
 average levels of cholesterol at the outset of the study.
     As a result of the reductions in heart attacks and strokes in patients
 receiving the cholesterol lowering drug and those treated with the modern
 blood pressure lowering drugs, both parts of ASCOT were terminated early by
 the independent Data Safety Monitoring Board.
     Commenting on the importance of these results, Co-Chairman of the study,
 Professor Bjorn Dahlof, Associate Professor in the Department of Medicine at
 Sahlgrenska University Hospital/Ostra, University of Gothenburg, Sweden,
 said: "High blood pressure is a major public health problem. Despite the
 availability of effective blood pressure lowering drugs, many people who are
 being treated still suffer strokes, heart attacks and other related diseases,
 such as diabetes. Now, the evidence from ASCOT offers us a simple and
 effective combination of treatments which both control the blood pressure and
 lower cholesterol to more effectively reduce this risk. This is very
 important news for patients and their physicians."
     Following the study, the investigators believe that international
 recommendations for managing high blood pressure may need to be reviewed.
 Additionally, they suggest that most patients with hypertension should also
 be considered for a cholesterol lowering drug.
     However, they emphasise that patients taking beta-blockers and diuretics
 should not discontinue their treatment. The Co-Chairmen of the study,
 Professors Sever and Dahlof concluded: "Diuretics and beta-blockers are an
 effective and proven combination for lowering blood pressure and its
 associated risks. What ASCOT has shown is that for many patients the
 combination of newer drugs may be an even better option. Patients should
 discuss the implications of ASCOT with their physicians before any
 modification of treatment is considered."
     Note to Editors
     More than 330 million adults in Europe and North America suffer from high
 blood pressure which also affects a further 639 million men and women in the
 rest of the world (The Lancet, January 2005).
     About 80% of people with high blood pressure have additional uncontrolled
 cardiovascular risks (World Health Organization).
     The final results of the Blood Pressure Lowering Arm (BPLA) of ASCOT were
 published in The Lancet online (www.thelancet.com) on 4th September 2005:
     'Prevention of cardiovascular events with an antihypertensive regimen of
 amlodipine adding perindopril as required versus atenolol adding
 bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes
 Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised
 controlled trial'
     Bjorn Dahlof, Peter S Sever, Neil R Poulter, Hans Wedel, D Gareth
 Beevers, Mark Caulfield, Rory Collins, Sverre E Kjeldsen, Arni Kristinsson,
 Gordon T McInnes, Jesper Mehlsen, Markku Nieminen, Eoin O'Brien, Jan
 Ostergren, for the ASCOT investigators
     Lancet 2005, Volume 366, DOI:10.1016/S0140-6736(05) - 67185-1
     Explanations for the benefits seen are reviewed in a separate paper also
 published in The Lancet online (www.thelancet.com) on 4th September 2005:
     'Role of blood pressure and other variables in the differential
 cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes
 Trial-Blood Pressure Lowering Arm (ASCOT-BPLA)'
     Neil R Poulter, Hans Wedel, Bjorn Dahlof, Peter S Sever, D Gareth
 Beevers, Mark Caulfield, Sverre E Kjeldsen, Arni Kristinsson, Gordon T
 McInnes, Jesper Mehlsen, Markku Nieminen, Eoin O'Brien, Jan Ostergren, Stuart
 Pocock, for the ASCOT investigators
     Lancet 2005, Volume 366, DOI:10.1016/S0140-6736(05) - 67186-3
 
     Executive Committee of the ASCOT trial
 
     Peter S Sever
     Professor of Clinical Pharmacology & Therapeutics
     Imperial College London
     International Centre for Circulatory Health
     National Heart and Lung Institute
     St Mary's Hospital, London, UK
     Email: p.sever@imperial.ac.uk
 
     Bjorn Dahlof
     Associate Professor
     Department of Medicine
     Sahlgrenska University Hospital/Ostra
     University of Gothenburg, Sweden
     Email: bjorn.dahlof@scri.se
 
     Neil R Poulter
     Professor of Preventive Cardiovascular Medicine
     Imperial College London
     International Centre for Circulatory Health
     National Heart and Lung Institute
     London, UK
     Email: n.poulter@imperial.ac.uk
 
     Hans Wedel
     Professor of Epidemiology & Biostatistics
     Nordic School of Public Health
     Gothenburg, Sweden
     Email: hans.wedel@biostat.se
 
 
     Visit the ASCOT website:
 
     www.ascotstudy.org
 
 

SOURCE  ASCOT

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