Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2008 May;10(5):367-76.
doi: 10.1111/j.1751-7176.2008.07851.x.

The benefits of intensive lipid lowering in patients with stable coronary heart disease with normal or high systolic blood pressure: an analysis of the Treating to New Targets (TNT) study

John B Kostis  1 , Andrei Breazna, Prakash C Deedwania, John C LaRosa; Treating to New Targets Steering Committee and Investigators
Affiliations
Randomized Controlled Trial

The benefits of intensive lipid lowering in patients with stable coronary heart disease with normal or high systolic blood pressure: an analysis of the Treating to New Targets (TNT) study

John B Kostis et al. J Clin Hypertens (Greenwich). 2008 May.

Abstract

This post-hoc analysis of the Treating to New Targets (TNT) study evaluated the joint effects of managing low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP) on cardiovascular outcomes. Patients (N=9739) with clinically evident, stable coronary heart disease (CHD) were randomized to atorvastatin 10 or 80 mg/d. The primary end point was occurrence of a first major cardiovascular event. At 3 months' follow-up, patients were stratified according to SBP (< 140 mm Hg vs > or = 140 mm Hg) and tertiles of LDL-C. At 4.9 years' median follow-up, the rate of major cardiovascular events was reduced most in patients with lower LDL-C (P < .001) and in patients with SBP < 140 mm Hg (P = .014). A 42% relative risk reduction was observed for patients in the lowest LDL-C tertile with an SBP < 140 mm Hg, compared with patients in the highest LDL-C tertile with an SBP > or = 140 mm Hg. The effect of lower SBP on stroke was most pronounced in the lowest LDL-C tertile.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study design. aOnly patients who had both an LDL‐C and SBP measurement at 3 months were included in this post‐hoc study. CHD indicates coronary heart disease; LDL‐C, low‐density lipoprotein cholesterol; SBP, systolic blood pressure; CV, cardiovascular; MI, myocardial infarction.
Figure 2
Figure 2
Rate of major cardiovascular events (primary end point) by low‐density lipoprotein cholesterol (LDL‐C) tertiles and systolic blood pressure (SBP) <140 mm Hg or ≥140 mm Hg at month 3.
Figure 3
Figure 3
Rate of coronary heart disease death and nonfatal, non‐procedure‐related myocardial infarction (MI) by low‐density lipoprotein cholesterol (LDL‐C) tertiles and systolic blood pressure (SBP) <140 mm Hg or ≥140 mm Hg at month 3.
Figure 4
Figure 4
Rate of fatal and nonfatal stroke by low‐density lipoprotein cholesterol (LDL‐C) tertiles and systolic blood pressure (SBP) <140 mm Hg or ≥140 mm Hg at month 3.
See this image and copyright information in PMC

References

    1. The Pooling Project Research Group . Relationship of blood pressure, serum cholesterol, smoking habit, relative weight and ECG abnormalities to incidence of major coronary events: final report of the pooling project. J Chronic Dis. 1978;31:201–306. - PubMed
    1. Neaton JD, Wentworth D. Serum cholesterol, blood pressure, cigarette smoking, and death from coronary heart disease. Overall findings and differences by age for 316,099 white men. Multiple risk factor intervention trial research Group . Arch Intern Med. 1992;152:56–64. - PubMed
    1. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol‐lowering treatment: prospective meta‐analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–1278. - PubMed
    1. The seventh report of the Joint National Committee on prevention, Detection, evaluation, and treatment of high Blood pressure: the JNC 7 report. JAMA. 2003;289:2560–2572. - PubMed
    1. Turnbull F. Effects of different blood‐pressure‐lowering regimens on major cardiovascular events: results of pro‐spectively‐designed overviews of randomised trials. Lancet. 2003;362:1527–1535. - PubMed

Publication types

MeSH terms