The aim of this analysis was to comparatively evaluate the long-term effect of combining treatment with statins and angiotensina-converting enzyme (ACE) inhibitors on hemodynamic and laboratory parameters and on the incidence of major cardiovascular events (MACE) and other clinical outcomes in a well characterized Italian cohort.
Design and method:
We considered data from a subset of Brisighella Heart Study (BHS) participants who were consecutively evaluated in three epidemiological surveys between 2012 and 2020. For the purpose of this analysis, we excluded normotensive subjects and individuals with a low calculated 10-year CVD risk, hypertensive patients treated with antihypertensive drugs different from ACE inhibitors and patients who changed antihypertensive medications during follow-up. The remaining participants were divided into four groups depending on whether they were treated with (I) perindopril +/- amlodipine without statin treatment, (II) perindopril +/- amlodipine and atorvastatin, (III), an ACE inhibitor other than perindopril without statin therapy, (IV) an ACE inhibitor other than perindopril and statin therapy. The long-term (8 years) effects of the different combined treatment were compared among the pre-defined groups.
Over the follow-up period of 8 years, the proportion of subjects who developed MACE, type 2 diabetes mellitus and hyperuricemia, and the proportion of subjects who had a need for the intensification of antihypertensive treatment to improve blood pressure control were statistically different among the predefined groups (P < 0.05).
Based on our observations, the combined treatment with ACE inhibitors and statins in hypertensive patients seems to significantly reduce the risk of developing CVD in comparison with treatment with ACE inhibitors alone. This effect seems to be particularly impressive when treatment with perindopril (+/- amlodipine) is as-sociated to atorvastatin.