Open AccessThe Benefits of Intensive Lipid Lowering in Patients With Stable Coronary Heart Disease With Normal or High Systolic Blood Pressure: An Analysis of the Treating to New Targets (TNT) Study
Author(s) -
Kostis John B.,
Breazna Andrei,
Deedwania Prakash C.,
LaRosa John C.
Publication year - 2008
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2008.07851.x
Subject(s) - medicine , blood pressure , cardiology , atorvastatin , post hoc analysis , clinical endpoint , cholesterol , stroke (engine) , randomized controlled trial , mechanical engineering , engineering
This post‐hoc analysis of the Treating to New Targets (TNT) study evaluated the joint effects of managing low‐density lipoprotein cholesterol (LDL‐C) and systolic blood pressure (SBP) on cardiovascular outcomes. Patients (N=9739) with clinically evident, stable coronary heart disease (CHD) were randomized to atorvastatin 10 or 80 mg/d. The primary end point was occurrence of a first major cardiovascular event. At 3 months' follow‐up, patients were stratified according to SBP (<140 mm Hg vs ≥140 mm Hg) and tertiles of LDL‐C. At 4.9 years' median follow‐up, the rate of major cardiovascular events was reduced most in patients with lower LDL‐C ( P <.001) and in patients with SBP <140 mm Hg ( P =.014). A 42% relative risk reduction was observed for patients in the lowest LDL‐C tertile with an SBP <140 mm Hg, compared with patients in the highest LDL‐C tertile with an SBP ≥140 mm Hg. The effect of lower SBP on stroke was most pronounced in the lowest LDL‐C tertile.