Details der Publikation - Relative and cumulative effects of lipid and blood pressure control in the stroke prevention by aggressive reduction in cholesterol levels trial

Relative and cumulative effects of lipid and blood pressure control in the stroke prevention by aggressive reduction in cholesterol levels trial / Pierre Amarenco, Larry B. Goldstein, Michael Messig, Blair J. O'Neill, Alfred Callahan, Henrik Sillesen, Michael G. Hennerici, Justin A. Zivin, K.M.A. Welch, and on behalf of the SPARCL Investigators

BACKGROUND AND PURPOSE: The relative contributions of on-treatment low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), triglycerides, and blood pressure (BP) control on the risk of recurrent stroke or major cardiovascular events in patients with stroke is not well defined. - METHODS: We randomized 4731 patients with recent stroke or transient ischemic attack and no known coronary heart disease to atorvastatin 80 mg per day or placebo. - RESULTS: After 4.9 years, at each level of LDL-C reduction, subjects with HDL-C value above the median or systolic BP below the median had greater reductions in stroke and major cardiovascular events and those with a reduction in triglycerides above the median or diastolic BP below the median showed similar trends. There were no statistical interactions between on-treatment LDL-C, HDL-C, triglycerides, and BP values. In a further exploratory analysis, optimal control was defined as LDL-C <70 mg per deciliter, HDL-C >50 mg per deciliter, triglycerides <150 mg per deciliter, and SBP/DBP <120/80 mm Hg. The risk of stroke decreased with as the level of control increased (hazard ratio [95% confidence interval] 0.98 [0.76 to 1.27], 0.78 [0.61 to 0.99], 0.62 [0.46 to 0.84], and 0.35 [0.13 to 0.96]) for those achieving optimal control of 1, 2, 3, or 4 factors as compared to none, respectively. Results were similar for major cardiovascular events. - CONCLUSIONS: We found a cumulative effect of achieving optimal levels of LDL-C, HDL-C, triglycerides, and BP on the risk of recurrent stroke and major cardiovascular events. The protective effect of having a higher HDL-C was maintained at low levels of LDL-C..

Medienart:	E-Artikel

Erscheinungsjahr:	21 May 2009 2009
Erschienen:	21 May 2009

Enthalten in:	Zur Gesamtaufnahme - volume:40
Enthalten in:	Stroke - 40(2009), 7, Seite 2486-2492

Sprache:	Englisch

Beteiligte Personen:	Amarenco, Pierre [VerfasserIn] Goldstein, Larry B. [VerfasserIn] Messig, Michael [VerfasserIn] O'Neill, Blair J. [VerfasserIn] Callahan, Alfred [VerfasserIn] Sillesen, Henrik [VerfasserIn] Hennerici, Michael G., 1948- [VerfasserIn] Zivin, Justin A. [VerfasserIn] Welch, K. M. A. [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

Themen:	Adult Aged Aged, 80 and over Anticholesteremic Agents Atorvastatin Blood Pressure Cholesterol Cholesterol, HDL Cholesterol, LDL Female Heptanoic Acids Humans Hypercholesterolemia Ischemic Attack, Transient Male Middle Aged Pyrroles Risk Factors Secondary Prevention Stroke Treatment Outcome Triglycerides Young Adult

Anmerkungen:	Gesehen am 07.04.2022

Umfang:	7

doi:	10.1161/STROKEAHA.108.546135

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	1798127776

Internformat


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245	1	0	\|a Relative and cumulative effects of lipid and blood pressure control in the stroke prevention by aggressive reduction in cholesterol levels trial \|c Pierre Amarenco, Larry B. Goldstein, Michael Messig, Blair J. O'Neill, Alfred Callahan, Henrik Sillesen, Michael G. Hennerici, Justin A. Zivin, K.M.A. Welch, and on behalf of the SPARCL Investigators
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