A New HOPE: Statins and Anti-hypertensives in intermediate cardiovascular risk


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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.

What did you think of this week’s Mythbuster segment? Tweet us @roundstable!

The Papers

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

Mythbusters

1. http://www.rhinologyjournal.com/Rhinology_issues/109_Eccles

2. http://www.everydayhealth.com/cold-and-flu/colds-and-the-weather.aspx

3. http://www.cnn.com/2014/01/07/health/upwave-colds/

4. http://www.airguardmedical.com/html/content/Eccles%20R_2002.pdf

5. http://www.pnas.org/content/112/3/827.abstract

Good Stuff

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.

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