Eligibility mrc bhf heart protection study
Sponsored Links
This presentation is the property of its rightful owner.
1 / 46

ELIGIBILITY: MRC/BHF Heart Protection Study PowerPoint PPT Presentation


  • 100 Views
  • Uploaded on
  • Presentation posted in: General

ELIGIBILITY: MRC/BHF Heart Protection Study. Increased risk of CHD death due to prior disease: Myocardial infarction or other coronary heart disease; Occlusive disease of non-coronary arteries; or Diabetes mellitus or treated hypertension Age 40-80 years

Download Presentation

ELIGIBILITY: MRC/BHF Heart Protection Study

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


ELIGIBILITY: MRC/BHF Heart Protection Study

  • Increased risk of CHD death due to prior disease:

  • Myocardial infarction or other coronary heart disease;

  • Occlusive disease of non-coronary arteries; or

  • Diabetes mellitus or treated hypertension

  • Age 40-80 years

  • Total cholesterol >3.5 mmol/l (>135mg/dl)

  • Statin or vitamins not considered clearly indicated or contraindicated by patient’s own doctors


PRIOR DISEASE at BASELINE


AGE & SEX at BASELINE


TOTAL & LDL CHOLESTEROL at BASELINE


FACTORIAL TREATMENT COMPARISONS


VITAMINS: Average blood VITAMIN levelsduring follow-up


VITAMINS: CATARACT and FRACTURES


VITAMINS: COGNITIVE IMPAIRMENT(TICS-m <22/39) at Final Follow-up


VITAMINS: Summary of findings

  • This antioxidant vitamin regimen (600mg E, 250mg C & 20mg beta carotene daily) increased blood vitamin levels substantially

  • These vitamins appeared to be safe, but did not reduce the 5-year risks of any type of vascular disease, cancer or other major outcome

  • Given these results, continued recommendation of supplementation with such vitamins is difficult to justify


FACTORIAL TREATMENT COMPARISONS


STATIN USE: Compliance with study simvastatin or use of non-study statin


HPS assesses 2/3 of the effect of actually using 40mg simvastatin daily

  • Average proportions using statin during HPS: 5/6 of active group vs 1/6 of control group

  • LDL difference in HPS (active vs control group) is ~2/3 of LDL difference from actually using statin

  • Risk reduction in HPS (active vs control group) is ~2/3 of risk reduction from actually using statin

  • ACTUAL EFFECT = 1.5 x APPARENT EFFECT


SIMVASTATIN 40mg daily: Muscle symptoms


SIMVASTATIN 40mg daily: Safety monitoring


SIMVASTATIN: COGNITIVE IMPAIRMENT(TICS-m <22/39) at Final Follow-up


SIMVASTATIN: Average LDL DIFFERENCE(mmol/l ± se) by BASELINE LDL cholesterol


SIMVASTATIN: Average LDL DIFFERENCE (mg/dl ± se) by BASELINE LDL cholesterol


Statin-allocated

Placebo-allocated

Upper

LDL third

Lower

LDL third

SIMVASTATIN: MAJOR VASCULAR EVENT in upper & lower thirds of baseline LDL

30

25

% with major vascular events

20

15

1.5

2.0

2.5

3.0

3.5

4.0

Average LDL cholesterol (mmol/l)


SIMVASTATIN: Main conclusions

  • After allowance for non-compliance, 40mg daily simvastatin safely reducesthe risk of heart attack, of stroke, and of revascularisation by about one-third

  • 5 years of statin treatment typically prevents these “major vascular events” in about:

  • 100 of every 1000 people with previous MI

  • 80 " " " other CHD

  • 70 " " " cerebrovascular disease

  • 70 " " " other arterial disease

  • 70 " " " diabetes (age 40+)

  • irrespective of cholesterol level(or age, or sex, or other treatments)


Millions of people with relevant conditions


  • Login