Cardiovascular Deaths are Reduced Through Risk Factor Intervention

FOR IMMEDIATE RELEASE

For More Information: Bob Schwadron 212-468-3616

CARDIOVASCULAR DEATHS ARE REDUCED THROUGH RISK FACTOR INTERVENTION

Healthy Life Style Programs Benefit At Risk Hypertensive Men, American Journal of Hypertension Study Finds

NEW YORK, NY -- Lives are saved when older men with high blood pressure and cardiovascular risk factors, such as high cholesterol levels, diabetes or smoking, follow risk factor intervention programs and change their life style.

This was the key finding of a six year Swedish study of 508 at risk hypertensive men, ranging in age from 50 to 72. The study was designed to determine if a broad-based intervention approach was more effective than simply treating high blood pressure with medication only.

The patients were randomly divided into two groups -- 253 in the risk factor intervention group and 255 in usual care group. The additional intervention included group meetings to encourage lipid lowering and smoking cessation.

"An aggressive risk intervention program was effective in two ways," explains Michael Weber, MD, an editor of the American Journal of Hypertension, of the study published in the January issue. "First, the risk intervention program reduced cholesterol, improved control of diabetes and achieved smoking cessation in significantly more patients than was seen in the drug therapy only group.

"Of even greater importance was the number of lives saved," he continued. "The frequency of fatal and non-fatal cardiovascular events in the special intervention group was 29 percent lower than in the usual care group."

Dr. Weber said the study emphasizes the importance of identifying and dealing with a range of cardiovascular risk factors that exist in hypertensive patients.

"Until now, the main focus of therapy has been on high blood pressure itself and associated problems have often been ignored or given only scant attention," he explained. "This new research indicates that very encouraging clinical benefits, including the saving of lives, can result from a structured interventional program."

Nearly 50 million Americans have hypertension, called the silent killer because it prematurely ages the body's arteries and can lead to strokes, heart attacks and kidney disease, often without warning.

The study was conducted at a Hypertension Outpatient Clinic in Gothenburg, Sweden. All patients were seen bi-annually by the ten physicians who worked at the clinic. A special team that included a physician, a dietitian and three nurses were responsible for encouraging life style changes in patients and their spouses through a series of lectures.

Lead author of the study, "Mortality Rates In Treated Hypertensive Men With Additional Risk Factors Are High But Can Be Reduced," is Bjorn Fagerberg, MD, Department of Medicine, Goteborg University, Sahlgrenska University Hospital, Gothenburg, Sweden.

Entry criteria for the Gothenburg study were treatment for hypertension, serum cholesterol concentration of 6.5 mmol/L, diabetes mellitus with fasting blood glucose concentration above 7.0 mmol/L on two occasions or tobacco smoking.

The researchers found that 22 percent of the participants had diabetes, 29 percent smoked tobacco and 74 percent had serum cholesterol concentration above 6.5 mmol/L. Eight percent of the patients had suffered from acute myocardial infarction and six percent previously suffered a stroke.

The goal of the special intervention group was to drop cholesterol below 6.0 mmol/L; to help current smokers to quit and to discourage non-smokers for starting; and to reduce hemoglobin A1c (a blood test used in monitoring diabetes) in diabetic patients.

At follow-up (median 6.6 years), the researchers found that 64 patients died in the usual care group compared to 41 patients in the intervention group; the intervention group participants had net reductions in serum levels of total cholesterol of 6.3 percent, LDL cholesterol, 9.1 percent, and triglycerides, 7.5 percent. Mean in-trial total cholesterol below 6 mmol/L was found in 114 patients in the intervention group and 78 patients in the usual care group.

Among the 148 patients who were enrolled as smokers, the total mortality rate was 30.4 percent compared to 16.7 percent in nonsmokers. More smokers died in the usual care group, 26, than in the intervention group, 19. At the end of the study 160 patients were defined as nonsmokers in the intervention group and 135 in the usual care group.

Mean values and changes in serum hemoglobin A1c did not differ between the two groups. Reductions in mean in-trial blood glucose concentration and body weight were significantly greater in the intervention group than in the usual care group.

"The present results demonstrate the high mortality in a population of older, treated hypertensive patients with additional risk factors and a relatively high frequency of overt cardiovascular disease before entering the study," the researchers said. "The most important conclusion of the study is that the gloomy prognosis may be improved by a dedicated risk intervention program. This may be achieved without adversely affecting quality of life."

The American Society of Hypertension is the largest US organization devoted exclusively to hypertension and related cardiovascular diseases. The organization is committed to alerting physicians, allied health professionals and the public about new medical options, facts, research findings and treatment choices designed to reduce the risk of cardiovascular disease.

# # #