Low-cost drugs ? a cholesterol-lowering statin and a blood pressure-lowering drug ? as daily doses to 68,560 people with diabetes or heart disease for two years is estimated to have prevented 1,271 heart attacks and strokes.
The study is conducted by Kaiser Permanente and published online in the American Journal of Managed Care.
Kaiser Permanente developed the ALL initiative (Aspirin, Lisinopril and Lipid-Lowering Medication) in 2003 to reduce heart attacks and strokes by aggressively enrolling patients with heart disease or patients over 55 with diabetes in a therapeutic program that included the use of a triad of medications: low-dose aspirin, lovastatin and lisinopril.
The three-year clinical observational study found that offering 40 milligrams of lovastatin and 20 milligrams of lisinopril daily for two years to people not already on both drugs reduced their risk of hospitalization for heart attack or stroke the following year by more than 60 percent. Aspirin was not part of the study because it was over-the-counter and its use could not be measured through pharmacy records. However, it was separately estimated that 75 percent of study participants were already taking aspirin.
The study was conducted by Kaiser Permanente’s Care Management Institute in Oakland, Calif., which synthesizes knowledge on the best clinical practices to develop evidence-based care programs at Kaiser Permanente.
While previous research and clinical trials have shown that statins and angiotensin-converting enzyme inhibitors / angiotensin receptor blockers (ACE-I/ARB) individually reduce heart attacks and strokes, this is the first study to evaluate whether a consistent process could be developed to deliver the combined drugs to large numbers of people with diabetes and/or heart disease in realistic settings across a health care delivery system.
It is also the first study to evaluate how dramatically this program would affect clinical outcomes and hospitalization rates for heart attack and stroke.
Source: Kaiser Permanente, USA