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Drug Duo May Reduce Heart Attack And Strokes

A combination of cholesterol and blood pressure medicine can cut the incidence of attacks by up to 60 percent according to a new study.

According to Kaiser Permanente researchers, an inexpensive combination of one drug used to lower cholesterol and another medication used to lower blood pressure can reduce the incidence of heart attacks and strokes by as much as 60 percent.

“An American suffers a heart attack every 34 seconds,” explains Jesse Slome, executive director of the American Association for Critical Illness Insurance, a national trade organization. “Every 40 seconds, someone has a stroke, making these two of the most common critical illnesses afflicting individuals.”

Giving the drugs to nearly 70,000 people with cardiovascular disease or diabetes prevented an estimated 1,271 heart attacks and strokes in one year, Dr. James Dudl of Kaiser Permanente’s Care Management Institute and his colleagues reported in the American Journal of Managed Care.

According to reports, the inspiration for the study resulted from the Archimedes Model, a sophisticated computer simulation of the human body that predicted that lowering blood pressure and cholesterol simultaneously in those at the highest risk for cardiovascular problems. The Model predicted that the combination could reduce the incidence by 71 percent. The report noted that no study had been performed to test the prediction.

The Kaiser team chose two generic drugs, lovastatin for cholesterol and lisinopril for blood pressure, and offered them to 170,000 members of their managed-care programs in Northern and Southern California who suffered from heart disease or diabetes.

Some of the patients were already taking one of the drugs, but none of those selected was taking both. About 75 percent were also taking daily aspirin, but the researchers did not include aspirin in the protocol because they had no way to monitor usage.

They began the program in 2004 with nearly 70,000 patients. The team monitored compliance for two years by checking whether and how often patients refilled their prescriptions, then monitored health effects in the third year through the patients’ health records.

Some 47,268 patients had what the team termed “low exposure” to the drugs, taking them less than half the time. Their risk of hospitalization for heart attack or stroke was lowered by 15 events per 1,000 person-years, and an estimated 726 events were prevented.

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