To investigate the effects of simvastatin compared with standard treatment on cardiovascular outcomes and all-cause mortality in hypertensive patients with a high–normal level of total cholesterol (TC) and at least 1 additional cardiovascular risk factor.
In a randomized, open-label, blinded-endpoint trial, hypertensive patients, aged 50 years or older, with serum TC levels of 4.0–6.1 mmol/Lwere randomized to simvastatin 10 mg/day (n = 4953) or standard treatment (n = 4955) from 180 clinical centers in China. The primary outcome was the composite of non-fatal stroke, non-fatal myocardial infarction or death from cardiovascular causes. Secondary outcomes included all-cause mortality and cause-specific mortality.
The median follow-up was 41 months. The primary outcome was not significantly different between the two groups (hazard ratio [HR], 0.92; P = .51). There were trends towards reducing all-cause death and cancer death (HR, 0.79, P = 0.15; HR, 0.59, P = 0.06) with simvastatin treatment. Of note, the risk of noncardiovascular death was significantly reduced by 39% in simvastatin group (HR, 0.61, p = .03). There was no difference in cardiovascular death rates and other cardiovascular outcomes between the groups.
Simvastatin prevents noncardiovascular mortality compared with standard treatment in high-risk hypertensive patients with well-controlled hypertension and a high–normal level of total cholesterol, but not cardiovascular events. (ClinicalTrials.gov number, NCT01011660.)
1Department of Cardiology Fuwai Hospital China, People's Republic of
2Clinical Trial and Research Center Beijing Hypertension League Institute, Chinese Hypertension League China, People's Republic of
3Department of Traditional Chinese Medicine Fuwai Hospital China, People's Republic of