Combination treatment, according to researchers, reduces the risk of heart attacks and strokes by half

According to a worldwide study headed by Hamilton experts, a combined therapy of aspirin, statins, and at least two blood pressure medicines administered in set dosages can reduce the risk of fatal cardiovascular disease (CVD) by more than half.

The work was published in The Lancet and presented by Joseph at the European Society of Cardiology Congress at the same time.

The fixed-dose combination (FDC) therapies were examined both with and without aspirin versus control groups in a combined analysis of more than 18,000 patients without prior CVD from three large clinical trials. FDCs including aspirin cut the risk of heart attacks by 53 per cent, stroke by 51 per cent, and deaths from cardiovascular causes by 49 per cent.

The results were welcomed by international leaders in cardiovascular research.
Approximately 19 million people worldwide die of CVD and twice as many experience heart attacks or strokes every year.

About 80 per cent of cardiovascular events occur in individuals without a prior history of such illness, meaning effective preventative strategies including medications in people without CVD is essential, if the majority of heart attacks, strokes and related deaths in the world are to be prevented, the authors of the study state.

“This combination, either given separately or combined as a polypill, substantially reduces fatal and non-fatal CVD events,” said lead author Philip Joseph, associate professor of medicine at McMaster University, investigator at the Population Health Research Institute and cardiologist at Hamilton Health Sciences.

“The largest effects are seen with treatments that include blood pressure lowering agents, a statin and aspirin together, which can reduce fatal and non-fatal cardiovascular events by about half.

“The benefits are consistent at different blood pressure levels, cholesterol levels and with or without diabetes, but larger benefits may occur in older people.”

Joseph is the first author of the meta-analysis study by the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences. Salim Yusuf, executive director of the PHRI and Distinguished University Professor at McMaster, is the senior author and the Principal Investigator.