{"id":"fb16f564e457","type":"article","url":"https://hartvaat.nl/2016/05/26/bloeddruk-en-cholesterolverlaging-bij-personen-zonder-cardiovasculaire-ziekte-ho/","title":"Bloeddruk- en cholesterolverlaging bij personen zonder cardiovasculaire ziekte: HOPE-3","title_en":"Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","huisarts","internist"],"tags":["bloeddrukbehandeling","ezetimibe","ouderen","ramipril","soul-trial"],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa1600177","source_url":"https://doi.org/10.1056/NEJMoa1600177","authors":["Salim Yusuf","Eva Lonn","Prem Pais","Jackie Bosch","Patricio López-Jaramillo","Jun Zhu","Denis Xavier","Alvaro Avezum","Lawrence A Leiter","Leopoldo S Piegas","Alexander Parkhomenko","Matyas Keltai","Katalin Keltai","Karen Sliwa","Irina Chazova","Ron J G Peters","Claes Held","Khalid Yusoff","Basil S Lewis","Petr Jansky","Kamlesh Khunti","William D Toff","Christopher M Reid","John Varigos","Jose L Accini","Robert McKelvie","Janice Pogue","Hyejung Jung","Lisheng Liu","Rafael Diaz","Antonio Dans","Gilles Dagenais"],"significance":9,"published":"2016-05-26","source_date":"2016-05-26","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/preventie/preventie-bij-diabetes/"],"congress":"","summary_en":"The HOPE-3 trial showed that combined blood pressure and cholesterol lowering with rosuvastatin plus candesartan/hydrochlorothiazide reduced cardiovascular events by 29% in intermediate-risk persons without cardiovascular disease. The benefit was driven primarily by lipid lowering, with blood pressure lowering adding benefit mainly in those with elevated baseline pressures.","created":"2026-07-03T10:26:07Z","updated":"2026-07-03T18:38:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"NEJM HOPE-3-trial die gelijktijdige bloeddruk- en cholesterolverlaging onderzocht bij personen met intermediair risico zonder vastgestelde cardiovasculaire ziekte. Landmark trial voor primaire preventie.","abstract_original":"BACKGROUND: Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase the risk 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) or placebo 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 to combined 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, and the second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The median follow-up was 5.6 years. RESULTS: The decrease in the LDL cholesterol level was 33.7 mg per deciliter (0.87 mmol per liter) greater in the combined-therapy group than in the dual-placebo group, and the decrease in systolic blood pressure was 6.2 mm Hg greater with combined therapy than with dual placebo. The first coprimary outcome occurred in 113 participants (3.6%) in the combined-therapy group and in 157 (5.0%) in the dual-placebo group (hazard ratio, 0.71; 95% confidence interval [CI], 0.56 to 0.90; P=0.005). The second coprimary outcome occurred in 136 participants (4.3%) and 187 participants (5.9%), respectively (hazard ratio, 0.72; 95% CI, 0.57 to 0.89; P=0.003). Muscle weakness and dizziness were more common in the combined-therapy group than in the dual-placebo group, but the overall rate of discontinuation of the trial regimen was similar in the two groups. CONCLUSIONS: The combination of rosuvastatin (10 mg per day), candesartan (16 mg per day), and hydrochlorothiazide (12.5 mg per day) was associated with a significantly lower rate of cardiovascular events than dual placebo among persons at intermediate risk who did not have cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; ClinicalTrials.gov number, NCT00468923.)."}