ASCOT (medicine)

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ASCOT - short for Anglo-Scandinavian Cardiac Outcomes Trial - is a large European clinical trial that enrolled 19,342 hypertensive patients. At the beginning of April 2003, The Lancet published the results of the partial study under the name ASCOT-LLA (LLA for lipid-lowering arm) that highlighted the benefit of the additional administration of the statin atorvastatin . As a result, the other study arms such as ASCOT-BPLA were also published.

ASCOT-LLA

Study planning

First, the effects of two antihypertensive drugs were compared. Patients selected by general practitioners had to have at least three cardiovascular risk factors in order to qualify for participation in the study. The effect of atorvastatin was also compared to placebo , with a requirement that patients have a total cholesterol of 250 mg / dL (6.5 mmol / L) or less. The purpose of this study was to examine the effects of a statin on patients with normal cholesterol levels .

Study participants

The study population was made up of 95% whites and 81% men and had a mean age of 63 years. The mean total cholesterol was 213 mg / dl (5.5 mmol / l), the LDL cholesterol 131 mg / dl (3.4 mmol / l), the HDL cholesterol 50 mg / dl (1.3 mmol / l).

Half of the 10,000 qualified patients received a placebo and the other half received 10 mg of atorvastatin daily. The study was planned for a period of 5 years, but due to statistically significant results it was discontinued after approx. 3.5 years.

Results

After 3.5 years, atorvastatin had reduced average total cholesterol levels by 24% and LDL cholesterol by 35%. The blood pressure values ​​were comparable for both groups during the study period and averaged 138/80 mm Hg at the end of the study.

Non-fatal heart attacks and deaths from heart disease were 36% lower in the atorvastatin group than in the placebo group. In addition, there were 27% fewer strokes , although no necessary statistical adjustment was made here. The overall mortality was (as opposed to study data of simvastatin not lowered).

ASCOT-BPLA

Due to the different blood pressure settings in the therapy arms, the validity of the study remains questionable.

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  1. ↑ Sever PS, Dahlöf B, Poulter NR, et al : Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial - Lipid Lowering Arm ( ASCOT-LLA): a multicentre randomized controlled trial . In: Lancet . 361, No. 9364, April 2003, pp. 1149-58. doi : 10.1016 / S0140-6736 (03) 12948-0 . PMID 12686036 .
  2. ↑ Dahlöf B, Sever PS, Poulter NR, et al : Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT- BPLA): a multicentre randomized controlled trial . In: Lancet . 366, No. 9489, 2005, pp. 895-906. doi : 10.1016 / S0140-6736 (05) 67185-1 . PMID 16154016 .
  3. ↑ at 2003; 34: 76-7
  4. ↑ at 2005; 36: 85-6

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