Efficacy of aspirin and statins in primary prevention of cardiovascularmortality in uncomplicated hypertensive participants

A Korean national cohort study

Chan Joo Lee, Jaewon Oh, Sang Hak Lee, seokmin kang, Donghoon Choi, HyeonChang Kim, Sungha Park

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Abstract

Introduction: To determine whether the addition of aspirin to a statin regimen is beneficial in reducing cardiovascular mortality, we analyzed data for uncomplicated hypertensive patients included in the Korea National Health Insurance sample cohort. Method: Among the 758 433 eligible participants aged 20 years or older in 2005, 31 115 participants were selected and divided into four groups: no-treatment group (N=19 628); aspirin alone group (N=4814); statins alone group (N=4717); and combined treatment group (N=1956). The mean follow-up duration was 94-13 months. The primary outcome of the study was all-cause and cardiovascular mortality from 2007 to 2013. Results: Treatment with aspirin alone [hazard ratio (HR), 0.62; 95% confidence interval (CI), 0.55-0.70; P>0.001), treatment with statins alone (HR, 0.48; 95% CI, 0.41- 0.57; P>0.001), and combined treatment (HR, 0.43; 95% CI, 0.34-0.55; P>0.001) were independently associated with reductions in all-cause mortality. Treatment with aspirin alone (HR, 0.66; 95% CI, 0.53-0.84; P>0.001), treatment with statins alone (HR, 0.46; 95% CI, 0.33- 0.64; P>0.001), and combined treatment (HR, 0.50; 95% CI, 0.31-0.79; P=0.003) were also independently associated with reductions in cardiovascular mortality. The addition of aspirin to statins was not associated with an additive benefit in reducing total mortality or cardiovascular mortality. Conclusion: Primary prevention with aspirin and/or statins is beneficial in reducing both all-cause and cardiovascular mortality in uncomplicated hypertensive participants. Nevertheless, as aspirin administration is associated with an increased risk of major bleeding, care must be taken to assess the risk/benefit of using aspirin in primary prevention.

Original languageEnglish
Pages (from-to)S33-S40
JournalJournal of Hypertension
Volume35
DOIs
Publication statusPublished - 2017 Jan 1

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Primary Prevention
Aspirin
Cohort Studies
Confidence Intervals
Mortality
Therapeutics
National Health Programs
Korea
Outcome Assessment (Health Care)
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Efficacy of aspirin and statins in primary prevention of cardiovascularmortality in uncomplicated hypertensive participants: A Korean national cohort study",
abstract = "Introduction: To determine whether the addition of aspirin to a statin regimen is beneficial in reducing cardiovascular mortality, we analyzed data for uncomplicated hypertensive patients included in the Korea National Health Insurance sample cohort. Method: Among the 758 433 eligible participants aged 20 years or older in 2005, 31 115 participants were selected and divided into four groups: no-treatment group (N=19 628); aspirin alone group (N=4814); statins alone group (N=4717); and combined treatment group (N=1956). The mean follow-up duration was 94-13 months. The primary outcome of the study was all-cause and cardiovascular mortality from 2007 to 2013. Results: Treatment with aspirin alone [hazard ratio (HR), 0.62; 95{\%} confidence interval (CI), 0.55-0.70; P>0.001), treatment with statins alone (HR, 0.48; 95{\%} CI, 0.41- 0.57; P>0.001), and combined treatment (HR, 0.43; 95{\%} CI, 0.34-0.55; P>0.001) were independently associated with reductions in all-cause mortality. Treatment with aspirin alone (HR, 0.66; 95{\%} CI, 0.53-0.84; P>0.001), treatment with statins alone (HR, 0.46; 95{\%} CI, 0.33- 0.64; P>0.001), and combined treatment (HR, 0.50; 95{\%} CI, 0.31-0.79; P=0.003) were also independently associated with reductions in cardiovascular mortality. The addition of aspirin to statins was not associated with an additive benefit in reducing total mortality or cardiovascular mortality. Conclusion: Primary prevention with aspirin and/or statins is beneficial in reducing both all-cause and cardiovascular mortality in uncomplicated hypertensive participants. Nevertheless, as aspirin administration is associated with an increased risk of major bleeding, care must be taken to assess the risk/benefit of using aspirin in primary prevention.",
author = "Lee, {Chan Joo} and Jaewon Oh and Lee, {Sang Hak} and seokmin kang and Donghoon Choi and HyeonChang Kim and Sungha Park",
year = "2017",
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language = "English",
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pages = "S33--S40",
journal = "Journal of Hypertension",
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TY - JOUR

T1 - Efficacy of aspirin and statins in primary prevention of cardiovascularmortality in uncomplicated hypertensive participants

T2 - A Korean national cohort study

AU - Lee, Chan Joo

AU - Oh, Jaewon

AU - Lee, Sang Hak

AU - kang, seokmin

AU - Choi, Donghoon

AU - Kim, HyeonChang

AU - Park, Sungha

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Introduction: To determine whether the addition of aspirin to a statin regimen is beneficial in reducing cardiovascular mortality, we analyzed data for uncomplicated hypertensive patients included in the Korea National Health Insurance sample cohort. Method: Among the 758 433 eligible participants aged 20 years or older in 2005, 31 115 participants were selected and divided into four groups: no-treatment group (N=19 628); aspirin alone group (N=4814); statins alone group (N=4717); and combined treatment group (N=1956). The mean follow-up duration was 94-13 months. The primary outcome of the study was all-cause and cardiovascular mortality from 2007 to 2013. Results: Treatment with aspirin alone [hazard ratio (HR), 0.62; 95% confidence interval (CI), 0.55-0.70; P>0.001), treatment with statins alone (HR, 0.48; 95% CI, 0.41- 0.57; P>0.001), and combined treatment (HR, 0.43; 95% CI, 0.34-0.55; P>0.001) were independently associated with reductions in all-cause mortality. Treatment with aspirin alone (HR, 0.66; 95% CI, 0.53-0.84; P>0.001), treatment with statins alone (HR, 0.46; 95% CI, 0.33- 0.64; P>0.001), and combined treatment (HR, 0.50; 95% CI, 0.31-0.79; P=0.003) were also independently associated with reductions in cardiovascular mortality. The addition of aspirin to statins was not associated with an additive benefit in reducing total mortality or cardiovascular mortality. Conclusion: Primary prevention with aspirin and/or statins is beneficial in reducing both all-cause and cardiovascular mortality in uncomplicated hypertensive participants. Nevertheless, as aspirin administration is associated with an increased risk of major bleeding, care must be taken to assess the risk/benefit of using aspirin in primary prevention.

AB - Introduction: To determine whether the addition of aspirin to a statin regimen is beneficial in reducing cardiovascular mortality, we analyzed data for uncomplicated hypertensive patients included in the Korea National Health Insurance sample cohort. Method: Among the 758 433 eligible participants aged 20 years or older in 2005, 31 115 participants were selected and divided into four groups: no-treatment group (N=19 628); aspirin alone group (N=4814); statins alone group (N=4717); and combined treatment group (N=1956). The mean follow-up duration was 94-13 months. The primary outcome of the study was all-cause and cardiovascular mortality from 2007 to 2013. Results: Treatment with aspirin alone [hazard ratio (HR), 0.62; 95% confidence interval (CI), 0.55-0.70; P>0.001), treatment with statins alone (HR, 0.48; 95% CI, 0.41- 0.57; P>0.001), and combined treatment (HR, 0.43; 95% CI, 0.34-0.55; P>0.001) were independently associated with reductions in all-cause mortality. Treatment with aspirin alone (HR, 0.66; 95% CI, 0.53-0.84; P>0.001), treatment with statins alone (HR, 0.46; 95% CI, 0.33- 0.64; P>0.001), and combined treatment (HR, 0.50; 95% CI, 0.31-0.79; P=0.003) were also independently associated with reductions in cardiovascular mortality. The addition of aspirin to statins was not associated with an additive benefit in reducing total mortality or cardiovascular mortality. Conclusion: Primary prevention with aspirin and/or statins is beneficial in reducing both all-cause and cardiovascular mortality in uncomplicated hypertensive participants. Nevertheless, as aspirin administration is associated with an increased risk of major bleeding, care must be taken to assess the risk/benefit of using aspirin in primary prevention.

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U2 - 10.1097/HJH.0000000000001279

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