Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease

ABSTRACT

Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase therisk of cardiovascular disease. Lowering both should reduce the risk of cardiovascular events substantially. METHODS In a trial with 2-by-2 factorial design, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to rosuvastatin (10 mg per day) orplacebo and to candesartan (16 mg per day) plus hydrochlorothiazide (12.5 mg per day)or placebo. In the analyses reported here, we compared the 3180 participants assigned tocombined therapy (with rosuvastatin and the two antihypertensive agents) with the 3168 participants assigned to dual placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, andthe second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The median follow-up was 5.6 years...