A New HOPE: Statins and Anti-hypertensives in intermediate cardiovascular risk
This week, Amol and Reena, internist at St. Michael’s hospital in Toronto, discuss the HOPE-3 trial.
HOPE-3 is a 2-by-2 double blind randomized placebo controlled trial, which found that statins were effective in preventing cardiovascular events in intermediate risk patients but anti-hypertensives were not. While candesartan and hydrochlorothiazide were not superior to placebo, rosuvastatin resulted in the lowering of cardiovascular events in intermediate-risk patients without cardiovascular disease.
Through a routine of good cop/bad cop, Amol and Reena discuss the implications of this trial on their clinical practice. Amol also reflects on the notion of pharmacological primary prevention versus public health initiatives.
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1. Cholesterol lowering: http://www.nejm.org/doi/full/10.1056/NEJMoa1600176#t=article
2. Blood pressure lowering: http://www.nejm.org/doi/full/10.1056/NEJMoa1600175#t=abstract
3. HOPE editorial: http://www.nejm.org/doi/full/10.1056/NEJMe1603504
1. Geography matters for the poor: http://www.nytimes.com/interactive/2016/04/11/upshot/100000004318776.mobile.html?_r=2
2. “The Nazi Patient”: http://annals.org/article.aspx?articleid=2510995
Music Credits (Creative Commons)
In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart
Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music
Vintage Dream – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/vintage-dream-loungejazzy-background-music
All tracks have been modified for the purposes of this podcast.