These results show a significant 28% risk reduction (p=0.041) in non-fatal strokes in elderly people with mild hypertension – an often untreated group – when treated with the AT1-receptor blocker Atacand® (candesartan cilexetil), compared to the control group.
SCOPE also reported a non-significant trend to reduced risk (11% risk reduction; p= 0.19) in the Atacand® treatment group, of major CV events; defined as a combined endpoint of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke. Lowering blood pressure was associated with maintained cognitive function, as measured by the MMSE (Mini Mental State Examination). There was no significant difference in the risk of heart attacks or cardiovascular death between treatment groups.
"SCOPE is a unique study," explains Professor Lennart Hansson, co-chair of the SCOPE Steering Committee. "It shows for the first time that treating mild hypertension in elderly people may have benefits on two counts. Reducing blood pressure with Atacand® offers real clinical benefits by significantly cutting people's risk of a non-fatal stroke."
"Importantly and perhaps contrary to current beliefs, SCOPE also shows that reducing blood pressure does not increase the risk of cognitive decline or the development of dementia in elderly people", continues Professor Hans Lithell. "These results have important implications for how we currently view and treat elderly patients with mild hypertension."
Interestingly, in addition to the positive effect on stroke, Atacand® also demonstrated a beneficial trend in onset of new diabetes (20% risk reduction ; p=0.083).
Hypertension, or high blood pressure, is the most common cardiovascular disorder. The World Health Organization estimates that there are nearly 691 million people throughout the world with hypertensive disease. The prevalence of high blood pressure (the number of people with the condition at any one time) is reported to be about 20 per cent of adult populations around the worldi. This figure is considerably higher in elderly people, and a prevalence of more than 50% has been reported.
SCOPE results are based on a randomised, double-blind, study in 15 countries to evaluate the effects of the AT1 -receptor blocker, Atacand® (candesartan cilexetil), on the clinical outcomes of 4,937 elderly patients (aged 70-89, average 76 years) with mild hypertension – typical of those found in everyday practice.
Atacand® has an established track record in blood pressure reduction with proven efficacy and placebo-like tolerability. Atacand® has accumulated some 4.2 million patient years of clinical experience. Previous studies have shown Atacand®'s efficacy in the treatment of hypertension - with studies showing superior efficacy to losartan, valsartan, hydrochlorothiazide and enalapril and equivalent efficacy to amlodipine. Atacand® also has placebo-like tolerability and is effective and well tolerated in elderly patients.
"We are pleased to have been able to sponsor such an innovative study," comments Dr Hamish Cameron, Vice-President and Head of Cardiovascular Therapy Area at AstraZeneca, the sole sponsors of SCOPE. "AstraZeneca is committed to cardiovascular medicine and are constantly striving to develop innovative therapeutic solutions and reduce the impact of cardiovascular disease."
* The Study on Cognition and Prognosis in the Elderly