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Efficacy of aspirin and statins in primary prevention of cardiovascular mortality in uncomplicated hypertensive participants: a Korean national cohort study

 Chan Joo Lee  ;  Jaewon Oh  ;  Sang-Hak Lee  ;  Seok-Min Kang  ;  Donghoon Choi  ;  Hyeon-Chang Kim  ;  Sungha Park 
 Journal of Hypertension, Vol.35(Suppl. 1) : 33-40, 2017 
Journal Title
 Journal of Hypertension 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; Aspirin/therapeutic use* ; Cause of Death ; Cohort Studies ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use* ; Hypertension/epidemiology ; Male ; Middle Aged ; Myocardial Ischemia/mortality ; Myocardial Ischemia/prevention & control* ; Primary Prevention ; Proportional Hazards Models ; Republic of Korea ; Stroke/mortality ; Stroke/prevention & control* ; Young Adult
aspirin ; hypertension ; primary prevention ; statins ; survival
INTRODUCTION: To determine whether the addition of aspirin to a statin regimen is beneficial in reducing cardiovascular mortality, we analyzed data for uncomplicated hypertensive patients included in the Korea National Health Insurance sample cohort. METHOD: Among the 758 433 eligible participants aged 20 years or older in 2005, 31 115 participants were selected and divided into four groups: no-treatment group (N = 19 628); aspirin alone group (N = 4814); statins alone group (N = 4717); and combined treatment group (N = 1956). The mean follow-up duration was 94 ± 13 months. The primary outcome of the study was all-cause and cardiovascular mortality from 2007 to 2013. RESULTS: Treatment with aspirin alone [hazard ratio (HR), 0.62; 95% confidence interval (CI), 0.55-0.70; P < 0.001), treatment with statins alone (HR, 0.48; 95% CI, 0.41-0.57; P < 0.001), and combined treatment (HR, 0.43; 95% CI, 0.34-0.55; P < 0.001) were independently associated with reductions in all-cause mortality. Treatment with aspirin alone (HR, 0.66; 95% CI, 0.53-0.84; P < 0.001), treatment with statins alone (HR, 0.46; 95% CI, 0.33-0.64; P < 0.001), and combined treatment (HR, 0.50; 95% CI, 0.31-0.79; P = 0.003) were also independently associated with reductions in cardiovascular mortality. The addition of aspirin to statins was not associated with an additive benefit in reducing total mortality or cardiovascular mortality. CONCLUSION: : Primary prevention with aspirin and/or statins is beneficial in reducing both all-cause and cardiovascular mortality in uncomplicated hypertensive participants. Nevertheless, as aspirin administration is associated with an increased risk of major bleeding, care must be taken to assess the risk/benefit of using aspirin in primary prevention.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
강석민(Kang, Seok Min) ORCID logo https://orcid.org/0000-0001-9856-9227
김현창(Kim, Hyeon Chang) ORCID logo https://orcid.org/0000-0001-7867-1240
박성하(Park, Sung Ha) ORCID logo https://orcid.org/0000-0001-5362-478X
오재원(Oh, Jae Won) ORCID logo https://orcid.org/0000-0002-4585-1488
이상학(Lee, Sang Hak) ORCID logo https://orcid.org/0000-0002-4535-3745
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
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