Early use of lipitor in hypertension reduces heart attacks

NEW YORK -- The early addition of Lipitor® (atorvastatin calcium) Tablets to effective blood pressure lowering treatment maintained a significant 36 percent reduction in the relative risk of fatal or non-fatal heart attacks over five years, according to a new analysis.

This was a post-hoc analysis (designed and completed following the closure of the trial) of the lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA) follow-up period. A majority of patients who were treated with Lipitor or placebo during a three-year study went on to receive Lipitor during two years of post-study follow up. At the start of the study, patients had high blood pressure and additional cardiovascular risk factors but no coronary heart disease. ASCOT-LLA is one of the first studies to explore the benefit of controlling more than one cardiovascular risk factor at a time.

“These important results show that early initiation of Lipitor with an effective blood pressure lowering drug regimen may have significant clinical implications for reducing the risk of heart attacks,” said Professor Peter Sever, study principal investigator, professor of clinical pharmacology and therapeutics, International Centre for Circulatory Health at London's Imperial College. “It is vital that physicians use the right combination of treatments from the start to maximize the reduction in the risk of heart attacks and coronary heart disease death.”

The results were published online in the European Heart Journal.

“Patients with high blood pressure and other risk factors for cardiovascular disease are usually treated with blood pressure lowering medications first,” said Professor Bryan Williams, professor of medicine, University Hospitals NHS Trust, Leicester, United Kingdom, and chairman of the British Hypertension Society Guidelines working party.

“It is important to note, however, that many people with high blood pressure are also at sufficient risk of cardiovascular disease to benefit from statin therapy,” he said. “Even if patients are prescribed statins in this context, they are generally only treated with statins after lifestyle modifications have failed.

“This study highlights the importance of initiating medical treatment for both blood pressure and cholesterol as soon as possible, and raises questions about medical guidelines that do not focus on early intensive treatment of multiple risk factors, notably blood pressure and cholesterol, in patients with moderate cardiac risk,” he said.

Pfizer offers physicians and patients the option of Lipitor or a combination medication known as Caduet® (amlodipine besylate/atorvastatin calcium) that includes Lipitor and Norvasc® (amlodipine besylate).

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