A9360 Major Outcomes of Simvastatin in High-risk Hypertensive Patients with a High–normal Level of Total Cholesterol: from The Chinese Hypertension Intervention Efficacy Study (CHIEF)

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Objectives:To investigate the effects of simvastatin compared with standard treatment on cardiovascular outcomes and all-cause mortality in hypertensive patients with a high–normal level of total cholesterol (TC) and at least 1 additional cardiovascular risk factor.Methods:In a randomized, open-label, blinded-endpoint trial, hypertensive patients, aged 50 years or older, with serum TC levels of 4.0–6.1 mmol/Lwere randomized to simvastatin 10 mg/day (n = 4953) or standard treatment (n = 4955) from 180 clinical centers in China. The primary outcome was the composite of non-fatal stroke, non-fatal myocardial infarction or death from cardiovascular causes. Secondary outcomes included all-cause mortality and cause-specific mortality.Results:The median follow-up was 41 months. The primary outcome was not significantly different between the two groups (hazard ratio [HR], 0.92; P = .51). There were trends towards reducing all-cause death and cancer death (HR, 0.79, P = 0.15; HR, 0.59, P = 0.06) with simvastatin treatment. Of note, the risk of noncardiovascular death was significantly reduced by 39% in simvastatin group (HR, 0.61, p = .03). There was no difference in cardiovascular death rates and other cardiovascular outcomes between the groups.Conclusion:Simvastatin prevents noncardiovascular mortality compared with standard treatment in high-risk hypertensive patients with well-controlled hypertension and a high–normal level of total cholesterol, but not cardiovascular events. (ClinicalTrials.gov number, NCT01011660.)

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