CVD prevention better with ACE inhibitor–statin combo than monotherapy

In patients with hypertension, combined treatment with angiotensin-converting enzyme (ACE) inhibitors plus statins reduces the risk of developing cardiovascular disease (CVD) at a greater magnitude as compared with ACE inhibitor monotherapy, a study has found.

Researchers looked at a subset of Brisighella Heart Study (BHS) participants who were consecutively evaluated in three epidemiological surveys between 2012 and 2020. They excluded patients with normal blood pressure (BP), those with a low calculated 10-year CVD risk, hypertensive patients treated with BP-lowering drugs different from ACE inhibitors, and patients who changed their BP-lowering medications during follow-up.

The analysis included BHS participants who were grouped as follows: (1) those who received perindopril with or without amlodipine and without statin (n=132); (2) those who received perindopril with or without amlodipine plus atorvastatin (n=132); (3) those who received an ACE inhibitor other than perindopril with or without a calcium-channel blocker and without statin therapy (n=133); and (4) those who received an ACE inhibitor other than perindopril with or without a calcium-channel blocker plus statin therapy (n=145).

Over 8 years of follow-up, the incidence rates of major adverse cardiovascular events, type 2 diabetes mellitus, and hyperuricaemia markedly differed across the four predefined groups, in favour of the groups that received combined treatment with ACE inhibitors plus statins (p<0.05 for all). The same was true with the proportion of patients requiring intensification of BP-lowering treatment to improve BP control (p<0.05).

The findings suggest that treatment with ACE inhibitor—statin combination may be more beneficial than ACE inhibitors alone for CVD prevention in hypertensive patients.