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Are antihypertensive drugs less effective with an unhealthy lifestyle?

Researchers determined whether the effects of lipid-lowering and antihypertensive drugs are influenced by maintaining healthy lifestyles.

Maintaining a healthy lifestyle has been proven to be one of the most effective measures in the primary prevention of cardiovascular diseases.

Having a healthy diet, maintaining an optimal weight, abstaining from smoking, and engaging in moderate-to-high-intensity physical activity are all known to help prevent cardiovascular diseases.

Additionally, lipid-lowering and antihypertensive drugs have an undeniable role in reducing cardiovascular diseases in patients with certain risk factors. However, it is unclear whether or not these medications have additional effects on those who adhere to a healthy lifestyle.

A clinical trial published in JAHA evaluated the impact of lipid-lowering and antihypertensive drugs in addition to a healthy lifestyle in healthy adults.

In this clinical trial, the researchers recorded data from 12,521 participants regarding four healthy lifestyle factors including not smoking, physical activity, optimal body weight, and a healthy diet.

The participants were identified to be at intermediate risk of cardiovascular disease. They randomly assigned the participants to receive rosuvastatin (a lipid-lowering medication), candesartan/hydrochlorothiazide (an antihypertensive drug), their combination, or a placebo. They measured the outcomes by the cardiovascular events.

Participants with two or more healthy lifestyle factors had a lower rate of cardiovascular diseases compared with those with fewer factors.

Rosuvastatin reduced cardiovascular events in participants with two or more healthy lifestyle factors.

Also, they found that with combination therapy, candesartan/ hydrochlorothiazide tends to reduce cardiovascular disease only in participants with less than two healthy lifestyle factors.

The authors concluded that rosuvastatin alone and combined with candesartan/ hydrochlorothiazide is shown to be beneficial regardless of an individual’s healthy lifestyle status.

However, the benefits of these drugs were limited in those with a less healthy lifestyle. Thus, the results of this study suggest that an overall healthy lifestyle would be beneficial in reducing cardiovascular events along with these lipid-lowering and antihypertensive drugs.

Written by Nima Makhdami, M.D.

Reference: Dagenais, G. R., Jung, H., Lonn, E., Bogaty, P. M., Dehghan, M., Held, C., … & Lopez‐Jaramillo, P. (2018). Effects of Lipid‐Lowering and Antihypertensive Treatments in Addition to Healthy Lifestyles in Primary Prevention: An Analysis of the HOPE‐3 Trial. Journal of the American Heart Association7(15), e008918.

Nima Makhdami
Nima Makhdami
Nima has experience as an emergency room physician and clinical research associate. He also has experience in medical literature, clinical data analysis and was a member of a research team for several published articles. He is working on several clinical research projects at the University of Toronto, McMaster University, and Western University. Writing for Medical News Bulletin has allowed Nima to follow his passion for medical writing. He is also passionate about internal medicine and hopes to continue his education in internal medicine residency in the near future. He enjoys playing piano and abstract painting.


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